BNP和cTnI在脓毒症心肌功能障碍中的诊断意义

Diagnostic Significance of Brain Natriuretic Peptide and Cardiac Troponin I in Sepsis Induced Myocardial Dysfunction

目的:通过比较脓毒症患者脑钠肽(BNP)和肌钙蛋白I(cTnI)水平,探讨其在脓毒症心肌功能障碍中的诊断意义。方法:共入选53例严重脓毒症患者,入院后24h进行心脏超声检查左室射血分数(LVEF),将患者分为29例LVEF>40%组和24例LVEF≤40%组,检测患者BNP和cTnI水平,记录APACHEⅡ评分,并进行比较分析。采用Pearson相关分析BNP、cTnI与APACHEⅡ评分相关性,BNP、cTnI与LVEF相关性。结果:两组患者BNP和cTnI均升高,LVEF≤40%组BNP明显高于LVEF>40%组,差异有统计学意义(P<0.05)。死亡组BNP和cTnI明显高于存活组,差异有统计学意义(P<0.05)。BNP、cTnI与APACHEⅡ评分存在相关性(r=0.43,P<0.05;r=0.39,P<0.05)。BNP与LVEF呈负相关(-r=0.31,P<0.05),cTnI与LVEF无显著相关(P>0.05)。结论:脓毒症心肌功能障碍患者BNP和cTnI水明显升高,且BNP和cTnI升高提示预后不良。

Objective：To investigate the change of brain natriuretic peptide （BNP）, cardiac troponin I （cTnI） and evaluate its significance in sepsis induced myocardial dysfunction. Methods：53 patients with severe sepsis or septic shock were involved. After 24h admission according to cardiac ultrasound examination for left ventricular ejection fraction （LVEF）, the patients were divided into 21 cases of LVEF≤40%group and 29 cases of LVEF〉40%group. BNP, cTnI and APACHEⅡscore of all patients were measured. The correlation was calculated between BNP, cTnI and APACHEⅡscore, LVEF. Results：BNP and cTnI in two groups increased. BNP in LVEF≤40%group was significantly higher than that of LVEF〉40%group （P〈0.05）. BNP and cTnI in the death group was significantly higher than that of in the survival group （P〈0.05）. BNP and cTnI both indicated a positive correlation to APACHEⅡscore （r=0.43, P〈0.05;r=0.39, P〈0.05）. BNP indicated a negative correlation to LVEF （-r=0.31, P〈0.05）. cTnI didn’t indicate a correlation to LVEF （P〉0.05）. Conclusion：BNP and cTnI significantly increased in patients with sepsis induced myocardial dysfunction. The increase of BNP and cTnI correlated with poor prognosis.