心肌肌钙蛋白T和CK在老年重症肺炎患者中的临床意义及对预后的影响

Clinical significance of serum cardiac troponin T and creatine kinase levies in elderly patients with severe pneumonia

目的探讨血清心肌肌钙蛋白T（cTnT）和CK在老年重症肺炎患者中的临床意义及对预后的影响。方法观察181例老年重症肺炎患者入院后3d内最高cTnT、CK测值和APACHEII评分，并对3者进行相关性分析。将患者分为cTnT正常组和升高组，比较两组的APACHEII评分和病死率。依据预后分为生存组和死亡组，比较两组cTnT、CK测值的变化。结果cTnT正常组APACHEII评分和死亡例数与升高组差异有统计学意义（P〈005）。生存组cTnT、CK测值和APACHEII评分与死亡组差异均有统计学意义（均P〈0．01），cTnT、CK与APACHEII评分3者之间呈正相关（均P〈0.01）。生存组cTnT、CK和APACHEII评分为（0．056±0．023）ng／ml、（13567±2071）μg／L和（17．4±2．8）分；死亡组cTnT、CK和APACHEII评分为（0．92±0.035）ng／ml、（210．22±32．6）μg／L和（24．8±5．6）分。结论老年重症患者cTnT、CK升高较常见，cTnT、CK监测对判断老年重症肺炎的预后具有一定临床意义。

Objective To investigate the clinical significance of serum cardiac tropinin T （cTnT） and creatine kinase （CK） levels in elderly patients with sever pneumonia. Methods Serum cTnT and CK levels were measured and APACHE II scores were assessed in 181 elderly patients with severe pneumonia within 3d after adimission. Patients were stratified into elevated and normal cTnT groups accordig to serum cTnT levels. Results There were significant differences in APACHE II score and mortality between the elevated and normal cTnT groups （P〈0.05）. Serum cTnT levels were positively correlated with CK levels and APACHE II scores （P〈0.01）. Serum cTnT, CK and APACHE II score in the survival group were 0.056±0.023 ng/ml, 135.67 ± 20.71 p g/L and 17.4 ±2.8 respectively, while those in the fatal group were 0.92 ± 0.035ng/ml, 210.22 ± 32.6 μg/L and 24.8 ±5.6 respectively. Conclusion Serum cTnT and CK levels can be used for evaluation of the prognosis in elderly patients with severe pneumonia.