脓毒症心肌病患者cTnI IMA和CK-MB浓度水平变化及与预后的关系

Changes of cTnI,IMA and CK-MB levels in Patients with Septic Cardiomyopathy and their Relationship between the levels and Prognosis

目的:探讨脓毒症心肌病患者心肌肌钙蛋白I(cTnI)、缺血修饰白蛋白(IMA)和肌酸激酶同工酶(CK-MB)浓度水平变化及与预后的关系。方法:回顾性分析2011年2月至2016年2月本院收治的90例脓毒症心肌病患者临床资料,依据患者1个月内生存情况分为存活组和死亡组,比较两组一般资料,检测两组不同时间点内(确诊第1天、第6、12天)血清cTnI、IMA和CK-MB浓度水平,并分析脓毒症心肌病患者cTnI、IMA和CK-MB浓度水平与其预后的相关性。结果:90例患者1个月内共有51例存活,39例死亡,存活组APACHEⅡ评分、cTnI、IMA、CK-MB较死亡组明显低,差异有统计学意义(P<0.05),存活组确诊第1天、第6、12天cTnI、IMA、CK-MB较死亡组明显低(P<0.05);Logistic回归分析cTnI、IMA、CK-MB升高是影响脓毒症心肌病患者预后的高危因素。结论:脓毒症心肌病患者cTnI、IMA和CK-MB浓度水平明显升高,且cTnI、IMA、CK-MB升高对脓毒症心肌病患者预后影响显著。

Objective： To investigate changes in levels of cardiac troponin I（ cTnI）,ischemia modified albumin（ IMA） and creatine kinase isoenzyme（ CK-MB） in patients with septic cardiomyopathy and their relationship with the prognosis. Methods： The clinical data of 90 patients with septic cardiomyopathy who were admitted to the hospital from February 2011 to February 2016 were retrospectively analyzed. The patients were divided into the survival group and the death group according to the survival within 1 month,and the general datawere compared between the two groups. Levels of cTnI,IMA and CK-MB in the two groups were detected at different time points（ the day of diagnosis,the6 th and12 thday）. The correlation between levels of cTnI,IMA and CK-MB in patients with septic cardiomyopathy and the prognosis was analyzed. Results： 51 cases survived and 39 died among the 90 patients within 1 month. The APACHE II score,levels of cTnI,IMA and CK-MB in the survival group were significantly lower than those in the death group（ P〈0.05）. Levels of cTnI,IMA and CK-MB in the survival group on the day of confirmed diagnosis,on the 6 th and 12 th days were significantly lower than those in the death group（ P〈0. 05）. Logistic regression analysis showed that increased cTnI,IMA and CK-MB were high risk factors influencing the prognosis of patients with septic cardiomyopathy. Conclusion： Levels of cTnI,IMA and CK-MB are obviously higher in patients with septic cardiomyopathy. The increased cTnI,IMA and CK-MB have significant effect on the prognosis of patients with septic cardiomyopathy.