超声心动图参数联合血清学指标预测脓毒症患者心肌损伤的临床研究

目的：探讨超声心动图检测参数及血清学指标在脓毒症患者心肌损伤中的变化，分析其对脓毒症心肌损伤风险的预测价值。方法：回顾性分析2017年12月至2021年4月本院ICU病房收治的脓毒症患者88例，根据患者是否合并心肌损伤分为心肌损伤组39例和非心肌损伤组49例；另选取同期健康体检者50例为对照组。所有患者均行超声心动图检查及HbA1c、MOP水平检测。比较各组三维超声心动图参数舒张期左室后壁厚度（LVPWd）、收缩期左室后壁厚度（LVPWs）、左房总射血容量（LASV），左房扩张指数（LAEI）、左房整体射血分数（LAEF）]及血清学指标（BNP、cTnI、HbA1c、MOP）差异。ROC曲线分析各指标预测脓毒症心肌损伤风险的价值。结果。三组LVPWd、LVPWs、LASV、LAEI、LAEF、HbA1c、MOP、BNP、cTnI比较，差异具有统计学意义（P<0.05）。LASV、LAEI、LAEF、HbA1c、MOP、BNP、cTnI值对照组>非心肌损伤组>心肌损伤组（P<0.05）；LVPWd、LVPWs水平对照组<非心肌损伤组<心肌损伤组（P<0.05）。Pearson相关性结果显示，LVPWd、LVPWs均与HbA1c、MOP、BNP及cTnI呈显著正相关（P<0.05）；而LASV、LAEI、LAEF与均与HbA1c、MOP、BNP及cTnI呈显著负相关（P<0.05）。ROC曲线分析显示，LVPWd、LVPWs、LASV、LAEI、LAEF、HbA1c、MOP、BNP、cTnI预测脓毒症心肌损伤患者的AUC分别为0.913、0.812、0.862、0.867、0.897、0.842、0.914、0.864、0.921，均具有一定准确性。结论 超声心动图、MPO、HbA1C联合检测对脓毒症心肌损伤风险预测价值高，可作为脓毒症心肌损伤临床预测的评估指标。

Changes in echocardiography, HbA1c and MOP levels and their predictive value in patients with myocardial injury with sepsis

Objective: To explore the evaluation value of echocardiography combined with glycohemoglobin (HbA1c) and myeloid peroxidase (MOP) detection on the risk of myocardial injury in sepsis. Methods:A retrospective analysis of 88 patients with sepsis admitted to the ICU ward of our hospital from December 2017 to April 2021. According to whether the patients had myocardial injury, they were divided into 39 cases in the myocardial injury group and 49 cases in the non-myocardial injury group; the other healthy patients were selected during the same period. Fifty cases of the physical examination were the control group. All patients underwent echocardiography and HbA1c and MOP levels. Compare the three-dimensional echocardiographic parameters of each group diastolic posterior wall thickness (LVPWd), systolic left ventricular posterior wall thickness (LVPWs), total left atrial ejection volume (LASV), left atrial dilatation index (LAEI), left Total Atrial Ejection Fraction (LAEF)] and serological indicators (BNP, cTnI, HbA1c, MOP) differences. The ROC curve analyzes the value of each index in predicting the risk of septic myocardial injury, and Logistic regression analyzes the influencing factors of septic myocardial injury.Results: Comparison of the three groups of LVPWd, LVPWs, LASV, LAEI, LAEF, HbA1c, MOP, BNP, cTnI, the difference was statistically significant (P<0.05). LASV, LAEI, LAEF, HbA1c, MOP, BNP, cTnI value control group> non-myocardial injury group> myocardial injury group (P<0.05); LVPWd, LVPWs level control group