监测脓毒症患者肌钙蛋白I的临床意义

目的通过监测脓毒症患者血清肌钙蛋白I（cTnI）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／m1）57例和cTnI正常组（cTnI〈0．16ng／m1）28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（APACHEII）、多器官功能障碍综合征（MODS）发生率、机械通气使用率、EICU人住时间、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。

Clinical value of cardiac troponin I monitoring in patients affected with sepsis

Objective To study cardic troponin I （cTnI） changes in serum of patients affected with sepsis and analyze the value of cTnI monitoring for diagnosis and treatment of sepsis patients. Methods 85 patients with sepsis were selected from cases admitted into Emergency Intensive Care Unit （EICU） and divided into two groups by the level of cTnI, elevated group （cTnI 〉0.16ng/ml） and normal group （cTnI 〈0.16ng/ml）. The indices, including creatine phosphokinase MB isoenzyme （CK-MB）, acute physiology and chronic health evaluation II （APACHE II） score, incidence of multiple organ dysfunction syndrome （MODS）, utilization of mechanical ventilation, length of stay in EICU, total length of stay and case fatality ratio were observed for the two groups respectively. Results cTnI was elevated in 57 of 85 septic patients （67.06%）. Disparity of CK-MB between two observed groups was not statistically significant （P〉0.05）, But the indices of the elevated cTnI group were higher than those of the normal cTnI group （P〈0.05, P〈 0.01）. Conclusion Monitoring of cTnI will avail clinicians to judge in the early time the pathogenetic conditions of patients affected with sepsis, and has high predictive value as to patients＇ prognosis.