肌钙蛋白I和B型钠尿肽检测在老年脓毒症患者中的临床应用

The Clinical Value of Cardic Troponin I and BNP Detection in the Treatment of Sepsis in Elderly Patients

目的检测非心源性疾病老年脓毒症患者中肌钙蛋白I(cardic tropin I,cTnI)和B型钠尿肽(B type natriuretic peptide,BNP)数值的变化,探讨cTnI和BNP对脓毒症病情的严重程度与预后评估的价值。方法选取95例老年脓毒症患者(脓毒症组),选取同期体检的正常患者80例做对照。在入院24 h内采集血清并检测血清cTnI和BNP,使用APACHEⅡ评分表对患者进行APACHEⅡ评分;将APACHEⅡ评分按15分以下,15~25分、25分以上分为3个脓毒症亚组,比较并分析各组间cTnI及BNP数值的差异。按预后分为脓毒症死亡组和脓毒症存活组,比较2组间cTnI及BNP的差异。结果脓毒症组的cTnI、BNP和APACHEⅡ评分数值均高于正常查体组(均P<0.01);脓毒症存活组的cTnI、BNP和APACHEⅡ评分数值均低于脓毒症死亡组(均P<0.05)。3个脓毒症亚组间cTnI和BNP的差异明显(均P<0.05)。结论血清cTnI与BNP对评价危重患者病情严重程度和预测患者预后可能有一定的临床意义与价值。

Objective To explore the effect of cardic troponin I（cTnI） and B type natriuretic peptide（BNP） on the severity of senile sepsis and the value of cTnI and BNP detection in prognosis evaluation.Methods 95 elderly patients with sepsis were selected;80 normal physical examination people at the same time were chosen as the control.The detection of cTnI and BNP was performed within 24 hours after admission;according to APACHE Ⅱ scores,the patients were divided into 3 subgroups：group A（15 points）,group B（from 15 to 25 points） and group C（25 points）,the levels of cTnI and BNP of the 3 subgroups were compared and the difference among the 3 was analyzed;according to the prognosis,the patients were divided into 2 groups：sepsis death group and sepsis survival group and the difference in cTnI and BNP between the 2groups was analyzed.Results The levels of cTnI,BNP and the APACHE Ⅱ scores in sepsis groups were higher than those in control group（P〈0.05）;the levels of cTnI,BNP and the APACHE Ⅱ scores in sepsis survival group were lower than those in sepsis death group（P〈0.05）;there existed an obvious difference in the levels of cTnI and BNP among the 3 subgroups（P〈0.05）.Conclusions The levels of cTnI and BNP may be of certain clinical value in the evaluation of the disease severity of critical patients and in prognosis prediction.