监测脓毒症患者肌钙蛋白Ⅰ的临床意义

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目的通过监测脓毒症患者血清肌钙蛋白I(cTn)I的变化,研究cTnI在脓毒症患者诊治中的作用。方法选取急诊重症监护室(EICU)收治的脓毒症患者85例,按照cTnI的水平分为cTnI升高组(cTnI>0.16ng/m)l57例和cTnI正常组(cTnI<0.16ng/m)l28例。观察2组患者肌酸磷酸激酶同工酶(CK-MB)、急性生理和慢性健康状况评分II(APACHEI)I、多器官功能障碍综合征(MODS)发生率、机械通气使用率、EICU入住时间、总住院时间和住院病死率。结果 85例脓毒症患者中有57例患者肌钙蛋白I升高,升高率达到67.06%。2组患者CK-MB比较差异无统计学意义(P>0.05);cTnI升高组APACHEII评分、MODS发生率、机械通气使用率、ICU入住时间、总住院时间及住院病死率均高于cTnI正常组(P<0.05,P<0.01)。结论脓毒症患者肌钙蛋白I的测定可以有助于临床医生早期进行病情判断,并且对疾病的预后也有较高的预测价值。 Objective To investigate the role of cTnI in the diagnosis and treatment of sepsis patients by monitoring the changes of serum troponin I (cTn) I in patients with sepsis. Methods Totally 85 patients with sepsis admitted to the Emergency Intensive Care Unit (EICU) were divided into cTnI group (cTnI> 0.16ng / m) and normal cTnI group (cTnI <0.16ng / m) l28 cases. The CK-MB, APACHEI I, incidence of multiple organ dysfunction syndrome (MODS), mechanical ventilation rate, EICU admission time , Total hospital stay and hospital mortality. Results In 85 sepsis patients, 57 patients had elevated troponin I with an increase rate of 67.06%. There was no significant difference in CK-MB between the two groups (P> 0.05). The APACHEII score, the incidence of MODS, the rate of mechanical ventilation, ICU stay, total hospital stay and in-hospital mortality in cTnI elevated group were higher than cTnI normal Group (P <0.05, P <0.01). Conclusion The determination of troponin I in patients with sepsis can help clinicians to judge the disease early and have a high predictive value for the prognosis of the disease.
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