摘要
目的通过检测脓毒症患者血清降钙素原（PCT）、N末端脑钠肽前体（NT-pro BNP）、心肌酶（CK、CK-MB）及肌钙蛋白I（c Tnl）的水平,探讨脓毒症患者病情严重程度与心肌损害的关系。方法选择2011年7月-2014年2月入住我院ICU确诊的脓毒症和脓毒性休克患者各30例,另选择门诊健康体检者30例作为对照组。统计入选者的性别、年龄及当天的APACHEⅡ评分。血清PCT水平的监测采用双抗体夹心免疫发光法,血清NT-pro BNP、心肌酶（CK、CK-MB）及c Tnl水平的监测采用酶联免疫吸附法（ELISA）。结果脓毒症休克组血清PCT水平较脓毒症组及健康对照组均明显升高（P〈0.01）;脓毒症组血清PCT水平较健康对照组明显升高（P〈0.01）;脓毒症休克组APACHEⅡ评分较脓毒症组明显升高（P〈0.01）。脓毒症休克组血清NT-pro BNP及c Tnl水平较脓毒症组及健康对照组均明显升高（P〈0.01）;脓毒症组血清NTpro BNP及c Tnl水平较健康对照组明显升高（P〈0.01）;脓毒症休克组和脓毒症组血清CK及CK-MB较健康对照组升高（P〈0.05）;脓毒症休克组血清CK及CK-MB与脓毒症组比较差异无统计学意义（P〉0.05）。APACHEⅡ评分与脓毒症患者血清PCT水平呈正相关（r=0.912,P〈0.01）;脓毒症患者血清c Tnl与血清PCT、APACHEⅡ评分均呈正相关（r=0.895,P〈0.01;r=0.752,P〈0.01）;脓毒症患者血清NT-pro BNP与血清PCT、APACHEⅡ评分均呈正相关（r=0.716,P〈0.01;r=0.708,P〈0.01）。结论血清PCT水平及APACHEⅡ评分能较好地反映脓毒症患者病情的严重程度;血清c Tnl水平及NT-pro BNP水平升高说明脓毒症患者存在心肌损伤和心功能不全,且与脓毒症患者病情的严重程度相关。
Objective To explore the relationship between the severity of the patients with sepsis and myocardial injury by detecting the level of serum PCT, NT-proBNP,myocardial enzyme （CK, CK-MB） and troponin I（cTnl）. Methods Chose 30 patients with sepsis or septic shock at our hospital from Jul 2011 to Feb 2014 , the other 30 cases of healthy persons were chosen as control group. Compared the gender, age, the APACHE Ⅱ score. Monitored the level of serum PCT by double anti-body sandwich immunoassay, monitored the level of cTnl, myocardial enzymes, serum NT-proBNP and CK, CK-MB by en-zyme linked immunosorbent assay（ELISA）. Results The serum PCT levels in septic shock group were significantly increased than sepsis group and healthy control group （P〈0.01）. The serum PCT levels in septic group were significantly higher than the healthy control group （P〈0.01）. APACHEⅡscore in septic shock group were significantly higher than sepsis group （P〈0.01）. The levels of serum NT-proBNP and cTnl in septic shock group significantly increased than sepsis group and healthy control group （P〈0.01）. The levels of serum NT-proBNP and cTnl in septic group were significantly increased than the healthy control group （P〈0.01）;the levels of serum CK and CK-MB in septic shock group and sepsis group significantly increased than healthy controls group （P〈0.05）;the levels of serum CK and CK-MB in septic shock group and sepsis group had no significant differ-ence （P〉0.05）. APACHE Ⅱ score were positively correlated to serum PCT levels in patients with sepsis （r=0.912, P〈0.01）;the levels of serum cTnl in patients with sepsis were positively correlated to serum PCT and APACHEⅡscore （r=0.895,P〈0.01;r=0.752, P〈0.01）; the levels of serum NT-proBNP in patients with sepsis were positively correlated to serum PCT, APACHEⅡscore （r=0.716,P〈0.01,r=0.708, P〈0.01）. Conclusion The levels of serum PCT and APACHE Ⅱ score can reflect the severity of patients with sepsis; the levels of serum cTnl and NT-proBNP elevated in the patients with sepsis prove myocardial injury and cardiac dysfunction, and relate to the severity of patients with sepsis.
出处
《中国现代医药杂志》
2015年第1期30-33,共4页
Modern Medicine Journal of China
关键词
脓毒症
血清降钙素原
N末端脑钠肽前体
Sepsis
Serum procalcitonin
N terminal pro brain natriuretic peptide
