脓毒症心肌损伤生物标志物的研究进展

Advances in biomarkers of myocardial injury in sepsis

脓毒症是危重症患者的常见疾病，可并发心肌损伤，从而加重患者的病情严重程度，导致预后不良。尽早发现脓毒症并发心肌损伤，并及时给予相应的救治措施至关重要。心肌肌钙蛋白I（cTnI）、B型脑钠肽（BNP）、肌红蛋白（Mb）、肌酸激酶同工酶（CK-MB）等传统心肌损伤标志物容易受重症患者合并症的影响，对脓毒症心肌损伤的诊断价值降低。近年来关于心型脂肪酸结合蛋白（H-FABP）、微小RNA（miRNA）、可溶性髓样细胞触发受体-1（sTREM-1）、高迁移率族蛋白B1（HMGB1）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、组蛋白等脓毒症心肌损伤新型生物标志物的研究时有出现，本文就上述非传统心肌标志物对脓毒症并发心肌损伤的诊断价值进行综述，以期为临床提供一定的帮助。

Sepsis is a common disease in critical patients, which may lead to myocardial damage, thereby aggravating the severity of the patients＇ condition, and causing adverse prognosis. How to detect sepsis with myocardial injury as early as possible, and use corresponding treatment measures on time are essential. Cardiac troponin I （cTnI）, brain natriuretic peptide （BNP）, myoglobin （Mb）, MB isoenzyme of creatine kinase （CK-MB） and other traditional cardiac markers are easily affected by the complications of other critical diseases, thus the diagnostic value of those markers for myocardial injury of sepsis is reduced. In recent years, there have been some studies on heart-type fatty acid binding protein （H-FABP）, microRNA （miRNA）, soluble triggering receptor expressed on myeloid cell-1 （sTREM-1）, high mobility group protein B1 （HMGB1）, neutrophil gelatinase-associated lipocalin （NGAL）, histone and other new biomarkers of myocardial injury in septic patients. This article reviewed the value of these unconventional cardiac markers in the diagnosis of sepsis-induced myocardial injury, with the hope to provide some help for clinic.