血清超敏C反应蛋白、胱抑素C与脓毒性休克患者心功能、肾功能损伤的关系

Relationship between high-sensitivity C-reactive protein,cystatin C,and cardiac and renal function injury in patients with septic shock

目的检测脓毒性休克患者血清超敏C反应蛋白(hs-CRP)、胱抑素C(Cys C)水平,探讨其与脓毒性休克患者心功能、肾功能损伤的关系。方法选取2020年5月—2023年12月我院收治的脓毒性休克患者50例,纳入休克组。另选取同期健康体检者48名,纳入参照组。比较2组研究对象hs-CRP、Cys C水平,分析脓毒性休克患者血清hs-CRP、Cys C水平与患者左室射血分数(LVEF)、二尖瓣舒张早期血流峰速(E)/二尖瓣环舒张早期速度(E’)、血浆脑钠肽(BNP)、心肌肌钙蛋白Ⅰ(c TnⅠ)、肾小球滤过率(GFR)及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的关系。结果2组研究对象年龄、性别分布、身体质量指数(BMI)及基础疾病患病情况等方面的差异均无统计学意义(P>0.05)。休克组患者的血清hs-CRP水平[(181.01±37.39)mg/L]和血清Cys C水平[(2.62±0.25)mg/L]显著高于参照组[(38.78±10.55)mg/L、(0.96±0.15)mg/L],差异均有统计学意义(P<0.05)。休克组患者的血清hs-CRP水平与LVEF、E/E’、BNP、c TnⅠ水平、APACHEⅡ评分有关(P<0.05),与GFR无相关性(P>0.05);休克组患者的血清Cys C水平与GFR水平、APACHEⅡ评分有关(P<0.05),与LVEF、E/E’、BNP及c TnⅠ水平均无相关性(P>0.05)。结论脓毒性休克患者血清hs-CRP、Cys C水平均显著高于健康体验者,推测其可能与心肌细胞受损、炎症因子水平升高、肾血流量降低等因素有关,可作为评估脓毒性休克患者心、肾功能损伤的参考指标。

Objective This paper aims to measure the levels of high-sensitivity C-reactive protein(hs-CRP)and cystatin C(Cys C)in patients with septic shock and explore their relationship with cardiac and renal function injury.Methods Fifty patients with septic shock admitted to our hospital from May 2020 to December 2023 were selected as the shock group.An-other 48 healthy individuals undergoing routine health checks during the same period were selected as the reference group.The hs-CRP and Cys C levels were compared between the two groups.The relationship between serum hs-CRP and Cys C levels with left ventricular ejection fraction(LVEF),early diastolic mitral inflow velocity(E)/early diastolic mitral annular velocity(E'),brain natriuretic peptide(BNP),cardiac troponinⅠ(cTnⅠ),glomerular filtration rate(GFR),and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score in patients with septic shock was analyzed.Results No statistically significant differences were found between the two groups in terms of age,gender distribution,body mass index(BMI),and prevalence of underlying diseases(P>0.05).The serum hs-CRP levels[(181.01±37.39)mg/L]and serum Cys C levels[(2.62±0.25)mg/L]in the shock group were significantly higher than those in the reference group[(38.78±10.55)mg/L and(0.96±0.15)mg/L;P<0.05].In the shock group,serum hs-CRP levels were related to LVEF,E/E',BNP,cTnI levels,and APACHEⅡscore(P<0.05),but not related to GFR(P>0.05);serum Cys C levels were related to GFR levels and APACHE II score(P<0.05),but not related to LVEF,E/E',BNP,and cTnI levels(P>0.05).Con-clusion The hs-CRP and Cys C levels in patients with septic shock are significantly higher than those in healthy individuals,suggesting a potential link to myocardial cell damage,elevated inflammatory factor levels,and reduced renal blood flow.These parameters can serve as reference indicators for assessing cardiac and renal function injury in these patients.