|本期目录/Table of Contents|

[1]郝迪,陈兵.脓毒症患者急性心肌损伤的危险因素分析[J].天津医科大学学报,2020,26(03):230-233.
 HAO Di,CHEN Bing.Risk factors of acute myocardial injury with sepsis[J].Journal of Tianjin Medical University,2020,26(03):230-233.
点击复制

脓毒症患者急性心肌损伤的危险因素分析(PDF)
分享到:

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
26卷
期数:
2020年03期
页码:
230-233
栏目:
临床医学
出版日期:
2020-06-10

文章信息/Info

Title:
Risk factors of acute myocardial injury with sepsis
文章编号:
1006-8147(2020)03-0230-04
作者:
郝迪陈兵
(天津医科大学第二医院ICU,天津 300211)
Author(s):
HAO DiCHEN Bing
(Department of Critical Care Medicine, The Second Hospital, Tianjin Medical University, Tianjin 300211, China)
关键词:
脓毒症心肌损伤肌钙蛋白危险因素电解质水平
Keywords:
sepsismyocardial injurycardiac troponinrisk factorselectrolyte level
分类号:
R631
DOI:
-
文献标志码:
A
摘要:
目的:探讨脓毒症患者急性心肌损伤的危险因素。方法:将209例脓毒症患者,根据入院时肌钙蛋白I,分为心肌损伤组和非心肌损伤组。比较两组患者临床资料,并将单因素分析提示有显著性差异的因素纳入多因素Logistic回归分析,寻找脓毒症患者急性心肌损伤的独立危险因素。结果:非心肌损伤组病死率显著低于心肌损伤组,差异有统计学意义(P<0.05)。白细胞、血清钠离子为脓毒症患者急性心肌损伤的独立危险因素。结论:临床上,脓毒症患者应该在积极控制感染的情况下,密切监测电解质,及早给予干预措施。
Abstract:
Objective: To investigate the risk factors of acute myocardial injury in patients with sepsis. Methods: 209 patients were divided into myocardial injury group and non-myocardial injury group according to whether the level of troponin I during admission. After compared the clinical data between two groups, the factors showing significant difference from single factor analysis were included in multivariate Logistic regression analysis to find independent risk factors of acute myocardial injury in patients with sepsis. Results: The mortality rate in the non-myocardial injury group was significantly lower than that in the myocardial injury group(P<0.05). White blood cell counts and serum sodium ions were independent risk factors for acute myocardial injury in patients with sepsis. Conclusion: Early interventions should be provided and electrolyte levels should be monitored while actively controlling infections in clinic.

参考文献/References:

[1] Fleischmann C, Thomas-Rueddel D O, Hartmann M, et al. Hospital incidence and mortality rates of sepsis[J]. DtschArztebl Int, 2016, 113(10):159
[2] Liu Y Y, Chiang C H, Hung S C, et al. Hypoxia-preconditioned mesenchymal stem cells ameliorate ischemia/reperfusion-induced lung injury[J]. PLoS One, 2017, 12(11):e0187637
[3] Li X, Yuan Z, Chen J, et al. Microarray analysis reveals the changes of circular RNA expression and molecular mechanism in acute lung injury mouse model[J].Cell Biochem, 2019, 120:16658
[4] Yang Z, Qdaisat A, Hu Z H, et al. Cardiac troponin is a predictor of septic shock mortality in cancer patients in an emergency department: a retrospective cohort study[J]. PLoS One, 2016, 11(4):27077648
[5] Abdulaleem A, Mohamad H, Hani T, et al. Association between troponin-I levels and outcome in critically ill patients admitted to non-cardiac intensive care unit with high prevalence of cardiovascular risk factors[J]. BMC Anesthesiology, 2018, 18(1):54
[6] Singer M, Deutschman C S, Seymour C W, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8):801
[7] Zheng Z, Ma H, Zhang X, et al. Enhanced glycolytic metabolism contributes to cardiac dysfunction in polymicrobial sepsis[J]. J Infect Dis, 2017, 215(9):1396
[8] Bruni F D, Komwatana P, Soulsby M E, et al. Endotoxin and myocardial failure: role of the myofibril and venous return[J]. Am J Physiol, 1978, 235(2): H150
[9] Cunnion R E, Schaer G L, Parker M M, et al. The coronary circulation in human septic shock[J]. Circulation, 1986, 73(4):637
[10] Turillazzi E, Fineschi V, Palmiere C, et al. Cardiovascular involvement in sepsis[J]. Mediators Inflamm, 2016, 2016:8584793
[11] Kakihana Y, Ito T, Nakahara M, et al. Sepsis-induced myocardial dysfunction: pathophysiology and management[J]. J Intensive Care, 2016, 4:22
[12] Ehrman R R, Sullivan A N, Favot M J, et al. Pathophysiology, echocardiographic evaluation, biomarker findings, and prognostic implications of septic cardiomyopathy: a review of the literature[J]. Critical Care, 2018, 22(1):29724231
[13] Liu X, Wen M, Li X, et al. Beta1 receptor blocker decreases the myocardial inflammation in the sepsis adult rats through inhibition of TLR4/NF-KappaB signaling pathway[J]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 2019, 31(2):193
[14] Zaky A, Deem S, Bendjelid K, et al. Characterization of cardiac dysfunction in sepsis: an ongoing challenge[J]. Shock, 2014, 41(1):12
[15] Yu W K, Mcneil J B, Wickersham N E, et al. Vascular endothelial cadherin shedding is more severe in sepsis patients with severe acute kidney injury[J].Crit Care, 2019, 23(1):30658667
[16] Zheng Y, Feng K, Yang H, et al. IL-22/IL-22R1 axis is involved in myocardial injury of a mouse cecal ligation and puncture model[J]. Am J Transl Res, 2019, 11(2):998
[17] Wannamethee S G, Shaper A G, Lennon L, et al. Mild hyponatremia, hypernatremia and incident cardiovascular disease and mortality in older men: A population-based cohort study[J]. NMCD, 2015, 26(1):12
[18] Fisher L A, Ko N, Miss J, et al. Hypernatremia predicts adverse cardiovascular and neurological outcomes after SAH[J].Neurocrit Care, 2006, 5(3):180
[19] Arambewela M H, Somasundaram N P, Garusinghe C. Extreme hypernatremia as a probable cause of fatal arrhythmia: a case report[J]. J Med Case Rep, 2016, 10(1):272
[20] Koesters A, Engisch K L, Rich M M. Decreased cardiac excitability secondary to reduction of sodium current may be a significant contributor to reduced contractility in a rat model of sepsis[J].Crit Care, 2014, 18(2):R54

相似文献/References:

[1]高秋文,谢克亮,王卫娜,等.氢气对脓毒症小鼠存活率和肝脏损伤的保护作用[J].天津医科大学学报,2013,19(06):449.
 GAO Qiu-wen,XIE Ke-liang,WANG Wei-na,et al.Protective effects of hydrogen gas on survival rate and liver injury in septic mice[J].Journal of Tianjin Medical University,2013,19(03):449.
[2]高秋文,谢克亮,陈红光,等.Nrf2在富氢液减轻小鼠脓毒症氧化损伤中的作用[J].天津医科大学学报,2014,20(05):354.
 GAO Qiu-wen,XIE Ke-liang,CHEN Hong-guang,et al.Effect of Nrf2 in hydrogen-rich saline to reduce the oxidative damage in septic mice[J].Journal of Tianjin Medical University,2014,20(03):354.
[3]邵 帅,李广平,石昭昭,等.曲美他嗪对不稳定性心绞痛患者PCI术后心肌损伤的影响[J].天津医科大学学报,2016,22(02):97.
 SHAO Shuai,LI Guang-ping,SHI Zhao-zhao,et al.Effect of trimetazidine on myocardial injury in patients with unstable angina pectoris underwent undergoing percutaneous coronary intervention[J].Journal of Tianjin Medical University,2016,22(03):97.
[4]王彦峰,白 洁,李光明,等.血清降钙素原与肾上腺髓质素前体中段肽在婴幼儿细菌性肺炎诊疗中的临床研究[J].天津医科大学学报,2017,23(04):314.
 WANG Yan-feng,BAI Jie,LI Guang-ming,et al.Clinical research of serum procalcitonin and MR-pro-adrenomedullin in the diagnosis and treatment of bacterial pneumonia in infants[J].Journal of Tianjin Medical University,2017,23(03):314.
[5]齐 颖,陈 兵.脓毒性休克限制性液体复苏的临床研究[J].天津医科大学学报,2017,23(04):324.
 QI Ying,CHEN Bing.Clinical study on limited fluid resuscitation in septic shock[J].Journal of Tianjin Medical University,2017,23(03):324.
[6]杨蕊,许华,王兵,等.IL-18在脓毒症及脓毒症休克中预测死亡的作用[J].天津医科大学学报,2018,24(02):142.
 YANG Rui,XU Hua,WANG Bing,et al.Role of IL-18 in predicting mortality of patients with sepsis and septic shock[J].Journal of Tianjin Medical University,2018,24(03):142.
[7]杨宏伟,牛文彦.探讨uKIM-1、IL-6、T细胞亚群在脓毒症急性肾损伤中早期检测的意义[J].天津医科大学学报,2018,24(02):145.
 YANG Hong-wei,NIU Wen-yan.Value of measuring uKIM,IL-6 and T-cell subsets in sepsis patients with acute kidney injury[J].Journal of Tianjin Medical University,2018,24(03):145.
[8]黄 颖,曹 超,王 军,等.TLR4在脓毒症中对调节性T细胞功能活性的影响[J].天津医科大学学报,2018,24(06):492.
 HUANG Ying,CAO Chao,WANG Jun,et al.The effects of TLR4 on regulating the function of Tregs in sepsis[J].Journal of Tianjin Medical University,2018,24(03):492.
[9]吴 枫,李燕华,高玉雷,等.蛋白C活性联合D-二聚体在脓毒症和脓毒性休克患者病情评估中的预测价值研究[J].天津医科大学学报,2019,25(03):229.
 WU Feng,LI Yan-Hua,GAO Yu-Lei,et al.Predictive value of protein C activity combined with D-dimer in the evaluation of sepsis and septic shock[J].Journal of Tianjin Medical University,2019,25(03):229.
[10]郭 菲,王力军,么 颖,等.血浆组蛋白H4与脓毒症患者严重程度及预后关系研究[J].天津医科大学学报,2019,25(05):475.
 GUO Fei,WANG Li-jun,YAO Ying,et al.Prognostic value of plasma histone H4 in septic patients[J].Journal of Tianjin Medical University,2019,25(03):475.
[11]孟祥龙刘艳存陈鑫森等.卡托普利对脓毒症小鼠心肌损伤的保护作用及机制研究[J].天津医科大学学报,2022,28(05):503.
 MENG Xiang-long,LIU Yan-cun,CHEN Xin-sen,et al.The protective effect and mechanism of captopril on myocardial injury in septic mice[J].Journal of Tianjin Medical University,2022,28(03):503.

备注/Memo

备注/Memo:
作者简介 郝迪(1994-),女,住院医师,硕士在读,研究方向:脓毒症;通信作者:陈兵,E-mail:tisheng2008@163.com。
更新日期/Last Update: 2020-06-13