血清cTnI、CK-MB、NT-proBNP联合检验在脓毒症患儿中的作用探讨

Effect discussion of serum cTnI, CK-MB, NT-proBNP joint test in children with sepsis

目的探讨血清cTnI、CK—MB、NT—proBNP联合检验在脓毒症患儿中的作用。方法选择2015年5月～2016年1月间在我院就诊的60例脓毒症患儿的临床资料，按病情分为轻症脓毒症组（n=30）和重症脓毒症组（n=30），随机选择30例来我院进行健康体检的性别、年龄与脓毒症患儿匹配的健康儿童作为对照组，检测三组的CK-MB、cTnI，NT—proBNP水平，比较不同标志物单独检测及联合检测的灵敏度、特异性及阳性预测率。结果重症脓毒症组CK—MB、cTnI、NT—proBNP水平高于轻症脓毒症组及对照组，差异有统计学意义（P〈0．05）：轻症脓毒症组CK—MB、cTnI、NT—proBNP水平高于对照组，差异有统计学意义（P〈0．05）。CK—MB、cTnI的灵敏度高于NT—proBNP，cTnI、NT—proBNP特异性高于CK—MB，差异有统计学意义（P〈0．05）；联合检测的灵敏度、特异性及阳性预测率与三项标志物单独检测比较更高，差异有统计学意义（P〈0．05）。结论脓毒症患儿CK—MB、cTnI、NT—proB．NP水平高于健康者，在脓毒症的检测中三种标志物的临床价值存在一定的差别，联合应用能使灵敏度、特异性及阳性预测率大幅提升。使患者可以早期诊断。早期治疗．有利于改善预后。

Objective To investigate the effect of the serum cTnI, CK-MB, NT-proBNP combined effects in children with sepsis test. Methods A total of 60 children with sepsis who were selected from May 2015 to January 2016 in our hospital. They were divided into the mild sepsis group（n=30） and the severe sepsis group（n=30） according to the disease degree, 30 health cases in the control group, the objects were mached with sepsis children on the gender, age. CK-MB, cTnI,NT-proBNP levels of the three groups were detected, the sensitivity, specificity and positive predictive value of the different detection indicators detected separately and combined detection were compared. Results CK-MB, cTnI, NT-proBNP levels of the severe sepsis group were higher than the mild sepsis group and the control group, with sig- nificant difference among three groups （P〈0.05）; CK-MB, cTnI, NT-proBNP levels of the mild sepsis group were higher than the control group, with significant difference between two groups （P〈0.05）. The sensitive of CK-MB, cTnI were higher than NT-proBNP, The specificity of cTnI, NT-proBNP were higher than CK-MB, the difference were statistically significant （P〈0.05）; The sensitivity, specificity and positive predictive value of joint detection were higher than three indicators detected separately, the difference were statistically significant（P〈0.05）. Conclusion CK-MB, cTnI, NT-proBNP levels of the sepsis children is higher than healthy persons, certain differences exist in three clinical value of sepsis markers detected in, combined to make the sensitivity, specificity and positive forecasting rates increased dramatically, so that patients can be early diagnosis, early treatment ,will help to improve the prognosis.