Background Sepsis-induced myocardial dysfunction is a common complication and the main cause of mor- tality in patients with sepsis. At present, there is still lack of specific early diagnosis index of the disease. Ou...Background Sepsis-induced myocardial dysfunction is a common complication and the main cause of mor- tality in patients with sepsis. At present, there is still lack of specific early diagnosis index of the disease. Our study was aimed to investigate the diagnosis and prognosis evaluation value of b-type natriuretic peptide （BNP） combined with the ratio of early diastolic transmitral inflow velocity （E） to early diastolic mitral annulus velocity （e＇） （Ee＇） in sepsis-induced myocardial dysfunction, so as to apply them as early warning indicators of the disease. Methods Sixty-six cases of patients with sepsis were selected and divided into disorder group （myocardial dys- function, n=28） and normal group （normal myocardial function, n=38）. Ee＇ of patients at the same time of LVEF detection, plasma BNP levels and APACHE ]l score and the 28 d survival rate of the two groups were also deter- mined and compared. The correlations of between plasma BNP levels and Ee＇ in sepsis patients with myocardial dysfunction with LVEF, APACHE l] score and 28 d survival rate were analyzed, and the value of them in combi- nation for predicting the 28 d survival rate was analyzed. Results Compared with the normal group, Plasma BNP levels, Ee＇ and APACHE 1] scores in the disorder group were increased （P 〈 0.05）. The 28 d survival rate of the patients in the disorder group was lower than that in the normal group （42.68% vs. 73.68%; P 〈 0.05）. Com- pared with the survival patients in the disorder group, plasma BNP levels, Ee＇ and APACHE I[ scores of the dead patients in disorder group were higher, while LVEF in the dead patient in disorder group was lower （P 〈 0.05）. Spearman unconditional correlation analysis and Logistic multiple regression analysis model results showed that plasma BNP levels and Ee＇ in sepsis patients with myocardial dysfunction were correlated with LVEF, 28d sur- vival rate and APACHE lI score. ROC curve analysis showed that values of plasma BNP levels and Ee＇ in sepsis patients with myocardial dysfunction were better in predicting the 28 d survival rate, while their combination was the best. Conclusions Plasma BNP levels and Ee＇ in sepsis patients with myocardial dysfunction are correlated with the severity and prognosis, therefore, provide reference indexes for the assessment of severity and prognosis of patients with sepsis and myocardial dysfunction.展开更多
基金supported by Foshan City Health and Family Planning Bureau medical research project(No.20160229)
文摘Background Sepsis-induced myocardial dysfunction is a common complication and the main cause of mor- tality in patients with sepsis. At present, there is still lack of specific early diagnosis index of the disease. Our study was aimed to investigate the diagnosis and prognosis evaluation value of b-type natriuretic peptide （BNP） combined with the ratio of early diastolic transmitral inflow velocity （E） to early diastolic mitral annulus velocity （e＇） （Ee＇） in sepsis-induced myocardial dysfunction, so as to apply them as early warning indicators of the disease. Methods Sixty-six cases of patients with sepsis were selected and divided into disorder group （myocardial dys- function, n=28） and normal group （normal myocardial function, n=38）. Ee＇ of patients at the same time of LVEF detection, plasma BNP levels and APACHE ]l score and the 28 d survival rate of the two groups were also deter- mined and compared. The correlations of between plasma BNP levels and Ee＇ in sepsis patients with myocardial dysfunction with LVEF, APACHE l] score and 28 d survival rate were analyzed, and the value of them in combi- nation for predicting the 28 d survival rate was analyzed. Results Compared with the normal group, Plasma BNP levels, Ee＇ and APACHE 1] scores in the disorder group were increased （P 〈 0.05）. The 28 d survival rate of the patients in the disorder group was lower than that in the normal group （42.68% vs. 73.68%; P 〈 0.05）. Com- pared with the survival patients in the disorder group, plasma BNP levels, Ee＇ and APACHE I[ scores of the dead patients in disorder group were higher, while LVEF in the dead patient in disorder group was lower （P 〈 0.05）. Spearman unconditional correlation analysis and Logistic multiple regression analysis model results showed that plasma BNP levels and Ee＇ in sepsis patients with myocardial dysfunction were correlated with LVEF, 28d sur- vival rate and APACHE lI score. ROC curve analysis showed that values of plasma BNP levels and Ee＇ in sepsis patients with myocardial dysfunction were better in predicting the 28 d survival rate, while their combination was the best. Conclusions Plasma BNP levels and Ee＇ in sepsis patients with myocardial dysfunction are correlated with the severity and prognosis, therefore, provide reference indexes for the assessment of severity and prognosis of patients with sepsis and myocardial dysfunction.
