心肌损伤标记物对脓毒症心肌损伤的诊断价值

Diagnostic value of cardiac injury biomarkers in patients with septic myocardial dysfunction

目的探讨心肌损伤标记物对诊断脓毒症心肌损伤的临床意义。方法 41例严重脓毒症患者分为脓毒症心肌损伤组(A组,18例)和脓毒症无心肌损伤组(B组,23例)。采用电化学发光法和免疫抑制速率法测定两组患者的血浆N末端脑利钠肽前体(NT-proBNP)、肌钙蛋白T(TnT)和肌酸激酶同工酶(CK-MB),通过受试者工作特征曲线(ROC)比较不同心肌损伤标记物对脓毒症心肌损伤的诊断价值。结果 A组NT-proBNP和TnT高于B组(P<0.05),其ROC曲线下面积分别为0.708(95%可信区间0.635-0.778)和0.740(95%可信区间0.649-0.821)。结论血浆NT-proBNP和TnT可作为脓毒症心肌损伤的诊断指标。

Objective To study the clinical significance of plasma cardiac injury biomarkers in the diagnosis of sepsis-induced cardiac depression. Methods Plasma N-terminal pro-brain natriuretic peptide（NT-proBNP）, troponin T（TnT） and creatine kinase MB（CK-MB） were measured by electrochemiluminescence immunoassay and rate method in 41 patients with severe sepsis, who were with septic myocardial dysfunction（group A, 18 cases） and without （group B, 23 cases）. The receiver operating characteristic curve（ROC） was used to evaluate the diagnostic value of those biomarkers. Results Compared with group B, plasma levels of NT-proBNP and TnT were higher in group A （P〈0. 05）. The areas under ROC curves of NT-proBNP and TnT were 0. 708（95%CI 0. 635-0. 778） and 0. 740（95% CI 0. 649-0. 821）, respectively. Conclusion Plasma levels of NT-proBNP and TnT may be taken as the indicators for diagnosing myocardial depression in the patients with severe sepsis.