摘要
目的观察脓毒症心肌损伤患者血浆Apelin水平并探讨其与cTnI关系。方法入选79例脓毒症患者经肘静脉途径采血,测定血浆Apelin、cTnI、NT-pro BNP等指标;同期17例健康志愿者为对照(NC组)。结果①血浆Apelin水平,与NC组比较,A组有升高趋势(P>0.05)、B及C组有明显升高(P<0.01);与A组比较,B组有升高(P<0.05),C组升高(P<0.01);②血浆cTnI水平,与A组比较,B组有升高(P<0.05),C组升高(P<0.01);与B组比较,C组升高(P<0.05);③血浆NT-pro BNP水平,与NC组比较,A组差异无统计学意义(P>0.05),B、C组有升高(P<0.01);与B组比较,C组升高(P<0.05);④入院时APACHEⅡ评分,与NC组比较,A组差异无统计学意义(P>0.05),B、C两组差异有统计学意义(P<0.01);与B组比较,C组有升高但差异无统计学意义(P>0.05);⑤脓毒症相关心肌损伤患者血浆Apelin水平与cTnI水平有相关性(r=0.482,P<0.05),与NT-Pro BNP有正相关(r=0.517,P<0.05),与入院时APACHEⅡ得分有正相关(r=0.429,P<0.05)。结论脓毒症患者血浆Apelin水平升高,脓毒症相关心肌损伤患者血浆Apelin水平随病情加重而明显升高,与cTnI、NTPro BNP水平及APACHEⅡ相关,提示血浆Apelin参与脓毒症心肌损伤的病理生理过程,有一定的临床意义。
Objective To evaluate the plasma concentration of Apelin and cTnI in myocardial injury patients of severe sepsis. Methods 79 patients who was diagnosed as sepsis, were clinically divided into only sepsis group, septic myocar- dial injury group and septic shock myocardial injury group（ called A, B, C）. 17 volunteers as normal control（NC） group were enrolled in the study. The blood were collected from the ulnar vein at the time of been hospitalized. The concentration of plasma Apelin,cTnI and NT-pro BNP were measured. Results ①The lever of plasma Apelin, in B and C group was significantly increased compared with NC group （P 〈 O. O1 ） ;in B group was increased （P 〈 O. 05 ） and in C group was sig- nificantly increased（ P 〈 O. 01 ） compared with A group; ②The concentration of plasma cTnI, was increased in B group （P 〈0.05 ） and was significantly increased in C group（ P 〈 0.01 ） compared with A group;and was increased in C group compared with B group （ P 〈 0.05 ） ; ③The lever of plasma NT-pro BNP, was significantly increased in B and C group （ P 〈 O. O1 ） and was escalating tendency in A group （ P 〉 O. 05 ） compared with NC group ; was significantly increased in C group compared with B group（P 〈0.05 ） ;④The score of APACHE ]1 ,was significantly increased in B and C group（P 〈 O. O1 ） and was escalating tendency in A group （P 〉 O. 05 ） compared with NC group;and was escalating tendency in C group compared with B group（ P 〈 0.05 ） ;⑤The plasma Apelin concentration in myocardial injury patients of severe sep- sis and Septic shock was positive correlated with the concentration of eTnI （r = 0. 482, P 〈 O. 05 ） , and was correlated with the NT-ProBNP （ r = 0.517, P 〈 O. 05 ）, and was correlated with the score of APACHE 11 （ r = 0. 429, P 〈 0.05 ）. Conclu- sion The concentration of plasma Apelin elevated in patients with sepsis, especial increased in myocardial injury patients of severe sepsis and septic shock,was correlated with the concentration of cTnI, NT-ProBNP and the score of APACHE I1. Apelin might be involved in the pathogenesis of myocardial injury of severe sepsis and Septic shock.
出处
《中华全科医学》
2014年第5期691-693,752,共4页
Chinese Journal of General Practice
