老年重度脓毒症合并心肌抑制患者心肌损伤标记物变化及价值

目的探讨老年重度脓毒症合并心肌抑制患者心肌损伤标记物肌钙蛋白I、T(cTnI、cTnT)、肌酸激酶(CK)、肌酸激酶同工酶(CK—MB)变化及其判断预后的价值。方法43例老年重度脓毒症患者确诊后次日进行血浆心肌损伤标记物检测，连续3日行心脏超声监测其心功能，确定患者是否并发心肌抑制，比较两组心肌损伤标记物水平，并通过ROC曲线下面积比较心肌损伤标记物预测心肌抑制及不良预后的价值。结果并发心肌抑制者的血浆CK—MB、cTnI、cTnT水平明显升高，cTnI、cTnT预测心肌抑制的价值高于CK—MB。cTnI阳性患者死亡率高但无显著性差异。结论肌钙蛋白检测对预测老年脓毒症患者有无心肌抑制有较高价值，对不良预后无明显预测价值。

Changes and value of the cardiac injury biomarkers concentration of elderly severe sepsis patients with cardiac depression

Objective To study the cardiac inju ry biomarkers concentration of elderly severe sepsis patients with cardiac depression and their value on o utcome prediction.Methods 43 elderly severe sepsis pat ients were included,bl ood samples were taken in next morning of diagnosis for detection of cardiac inj ury biomarkers:CK,CK-MB,cTnT and cTnI.UCG were performed in consecutive 3 days after sepsis diagnosis for identification of cardiac depression.Patients were grouped according cardiac function.Levels of CK,CK-MB,cTnT and cTnI were compared between two groups.And area under ROC were measured and compared to e valuate the value of different biomarkers in predicting cardiac dysfunction and outcome. Results Leve ls of CK-MB,cTnT and cTnI were elevated in patients developing cardiac depres sion,and cardiac troponins were better than CK-MB in predicting cardiac depres sion,cTnI positive patients might have higher mortality,but no statistic dif ferent was found in this study.Conclusion Cardia c troponins are good biomarkers in predicting cardiac dysfunction of severe sepsis,but aren't so good in out come prediction.