血清肌钙蛋白Ⅰ、N末端B型利钠肽在脓毒症合并心肌病患者中的表达及对预后的评估价值

Expression of Serum Troponin I and N-terminal B-type Natriuretic Peptide in Patients with Sepsis Complicated with Cardiomyopathy and Its Prognostic Value

目的:探讨血清肌钙蛋白Ⅰ(cTnI)、N末端B型利钠肽(NT-proBNP)在脓毒症合并心肌病患者中的表达及对预后的评估价值。方法:选取2020年2月—2022年12月北京市昌平区医院收治的80例脓毒症合并心肌病患者作为研究组,另选取同期收治的78例单独脓毒症患者作为对照组。比较两组临床资料、血清cTnI、NT-proBNP水平,随访28 d记录疾病转归情况,并采用受试者工作特征(ROC)曲线分析脓毒症合并心肌病预后的预测价值。结果:研究组收缩压、氧合指数低于对照组,乳酸、急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分高于对照组,差异有统计学意义(P<0.05)。研究组血清cTnI、NT-proBNP水平高于对照组,差异有统计学意义(P<0.05)。经28 d随访,在研究组中,死亡55例(68.75%),生存25例(31.25%),死亡者血清cTnI、NT-proBNP水平均高于生存者,差异有统计学意义(P<0.05)。ROC曲线分析显示血清cTnI、NT-proBNP水平对脓毒症合并心肌病预后预测价值的AUC分别为0.854、0.897。结论:血清cTnI、NT-proBNP水平可反映脓毒症合并心肌病的病情,可作为预测脓毒症合并心肌病预后的指标。

Objective:To investigate the expression of serum cardiac troponin I(cTnI)and N-terminal B-type natriuretic peptide(NT-proBNP)in patients with sepsis complicated with cardiomyopathy and their prognostic value.Method:A total of 80 patients with sepsis combined with cardiomyopathy admitted to Beijing Changping Hospital from February 2020 to December 2022 were selected as the study group,and 78 patients with sepsis alone admitted to Beijing Changping Hospital during the same period were selected as the control group.The clinical data,serum cTnI and NT-proBNP levels of the two groups were compared.After 28 d of follow-up,the disease outcome was recorded,and the prognostic predictive value of sepsis complicated with cardiomyopathy was analyzed by receiver operating characteristic(ROC)curve.Result:The systolic blood pressure and oxygenation index of the study group were lower than those of the control group,and lactic acid and the scores of acute physiology and chronic health evaluation systemⅡ(APACHEⅡ)were higher than those of the control group,the differences were statistically significant(P<0.05).The levels of serum cTnI and NT-proBNP in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).After 28 d of follow-up,55 cases(68.75%)died and 25 cases(31.25%)survived in the study group,the levels of serum cTnI and NT-proBNP in the deceased were higher than those in the survivors,the differences were statistically significant(P<0.05).ROC curve analysis showed that the AUC of serum cTnI and NT-proBNP levels in predicting the prognosis of sepsis combined with cardiomyopathy was 0.854 and 0.897,respectively.Conclusion:Serum cTnI and NT-proBNP levels can reflect the condition of sepsis combined with cardiomyopathy,and can be used as prognostic indicators of sepsis combined with cardiomyopathy.