红细胞分布宽度联合肌钙蛋白Ⅰ在重症肺炎患者心肌损伤诊断中的应用

Application of erythrocyte distribution width combined with cardiac troponin Ⅰ in the diagnosis of myocardial injury in patients with severe pneumonia

目的探讨红细胞分布宽度(RDW)、肌钙蛋白Ⅰ(cTnⅠ)在重症肺炎患者血清中的变化及对心肌损伤的诊断价值。方法选取2014年1月~2019年12月江苏大学附属武进医院确诊的80例重症肺炎患者,根据其最后是否确诊伴有心肌损伤分为A组(29例,伴有心肌损伤)、B组(51例,无心肌损伤),选取同期江苏大学附属武进医院确诊的60例普通肺炎患者作为对照组。比较三组的外周血RDW、血清cTnⅠ水平。结果 A组患者的RDW、cTnⅠ检测结果高于B组、对照组,差异有统计学意义(P<0.05);B组和对照组患者的RDW、cTnⅠ检测结果比较,差异无统计学意义(P>0.05);ROC曲线分析结果显示,RDW诊断重症肺炎患者并发心肌损害的敏感性为88.51%,特异性为76.29%,AUC值为0.846;cTnⅠ诊断重症肺炎患者并发心肌损害的敏感性为94.20%,特异性为86.44%,AUC值为0.903;cTnⅠ联合RDW诊断重症肺炎患者并发心肌损害的敏感性为98.28%,特异性为92.01%,AUC值为0.951。结论重症肺炎患者可能并发心肌损伤,cTnⅠ联合RDW检查对于早期诊断具有一定的指导价值,对于临床治疗具有指导意义。

Objective To investigate the changes of erythrocyte distribution width(RDW) and cardiac troponin Ⅰ(cTnⅠ) in serum of patients with severe pneumonia and the diagnostic value of myocardial injury. Methods A total of 80 patients with severe pneumonia diagnosed in Wujin Hospital Affiliated to Jiangsu University from January 2014 to December 2019 were selected and divided into group A(29 cases, with myocardial injury) and group B(51 cases, without myocardial injury) according to whether they were finally diagnosed with myocardial injury. A total of 60 patients with common pneumonia confirmed by Wujin Hospital Affiliated to Jiangsu University during the same period were selected as the control group. The levels of peripheral blood RDW, serum cTnⅠ of the three groups were compared. Results The results of RDW and cTnⅠ in group A were higher than those in group B and control group, with statistically significant differences(P<0.05). Comparison of RDW and cTnⅠ test results between group B and control group showed no statistically significant differences(P>0.05). ROC curve analysis showed that the sensitivity, specificity and AUC of RDW in diagnosing severe pneumonia complicated with myocardial damage were 88.51%, 76.29% and 0.846 respectively. The sensitivity, specificity and AUC of cTnⅠ in the diagnosis of severe pneumonia complicated with myocardial damage were94.20%, 86.44% and 0.903 respectively. The sensitivity, specificity and AUC value of cTnⅠ combined with RDW in the diagnosis of severe pneumonia complicated with myocardial damage were 98.28%, 92.01% and 0.951 respectively.Conclusion Patients with severe pneumonia may be complicated with myocardial injury. The combination of cTnⅠ and RDW examination has certain guiding value for early diagnosis and has guiding significance for clinical treatment.