心肌酶及sTREM-1、HMGB1在脓毒症心肌损伤患者预后评估中的应用

Application of Myocardial Enzymes,sTREM-1 and HMGB1 in Prognosis Evaluation of Patients with Sepsis-Induced Myocardial Dysfunction

目的探究心肌酶及血清可溶性髓样细胞触发受体-1(sTREM-1)、高迁移率族蛋白1(HMGB1)在脓毒症心肌损伤(SIMD)患者预后评估中的应用。方法回顾性分析河南大学第一附属医院2020年8月至2022年8月123例SIMD患者,根据患者预后情况分为死亡组(38例)与存活组(85例),比较两组一般资料、天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、心肌型肌酸激酶同工酶(CK-MB)、sTREM-1、HMGB1等,并分析其与预后的关系。结果死亡组急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、序贯器官衰竭评分(SOFA)高于对照组(P<0.05);死亡组AST、CK、CK-MB水平高于存活组(P>0.05),但两组LDH水平差异无统计学意义(P>0.05);死亡组sTREM-1、HMGB1水平均高于对照组(P<0.05);Cox回归分析显示APACHEⅡ评分、SOFA评分、CK-MB、sTREM-1以及HMGB1与脓毒症心肌损伤患者预后密切相关(P<0.05)。结论心肌酶联合sTREM-1、HMGB1具有评估脓毒症心肌损伤患者的价值。

Objective To investigate the application of myocardial enzymes,serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and high mobility group box 1(HMGB1)in prognosis evaluation of patients with sepsis-induced myocardial dysfunction(SIMD).Methods A total of 123 patients with SIMD admitted to the First Affiliated Hospital of Henan University from August 2020 to August 2022 were reviewed.According to the prognosis,the patients were divided into death group(38 cases)and survival group(85 cases).General information,aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),serum sTREM-1 and HMGB1 were compared between the two groups.The relationship between above indicators and the prognosis was analyzed.Results The acute physiology and chronic health evalution scoring system(APACHEⅡ)score,sequential organ faliure assessment(SOFA)score and the levels of AST,CK and CK-MB in the death group were higher than those in the survival group(P<0.05),but there was no statistically significant difference in LDH level between the two groups(P>0.05).Serum sTREM-1 and HMGB1 levels in the death group were higher than those in the survival group(P<0.05).Cox regression analysis showed that the APACHEⅡ score,SOFA score,CK-MB,serum sTREM-1 and HMGB1 were closely related to the prognosis of patients with SIMD(P<0.05).Conclusion Myocardial enzymes combined with serum sTREM-1 and HMGB1 can help to evaluate the prognosis of patients with SIMD.