广州医药 ›› 2016, Vol. 47 ›› Issue (5): 33-35.DOI: 10.3969/j.issn.1000-8535.2016.05.012

• 论著 • 上一篇    下一篇

脑钠肽前体和心肌损伤标志物联合监测对老年脓毒症心肌损伤及预后评估的价值

白园园, 李康保, 王思荣   

  1. 广州市第一人民医院老年病科(广州 510180)
  • 收稿日期:2016-06-07 出版日期:2016-09-20 发布日期:2021-12-02
  • 基金资助:
    广东省省级科技计划项目(2013B021800039)

Study on myocardial injury and prognostic value for markers of myocardial damage and pro-brain natriuretic peptide in elderly sepsis

Bai Yuanyuan, Li Kangbao   

  1. Department of Geriatrics, Guangzhou First People's Hospital, Guangzhou 510180, China
  • Received:2016-06-07 Online:2016-09-20 Published:2021-12-02

摘要: 目的 探讨血浆脑利钠肽前体(proBNP)和心肌损伤标志物(CK-MB和cTnI)联合检测对老年脓毒症患者心肌损伤及预后评估的临床意义。方法 选择60例老年脓毒症患者按病情严重程度分为一般脓毒症组和严重脓毒症组,另选取同期在我院行健康体检的同龄人30例作为对照组。比较三组和不同预后患者血浆proBNP、cTNI、CK-MB水平及急性生理和慢性健康状态评分Ⅱ(APACHE Ⅱ) ,并对各指标进行相关性分析。结果 脓毒症患者血浆proBNP、cTnI水平高于对照组,且严重脓毒症组APACHEⅡ评分高于一般脓毒症组(均P<0. 05);死亡组患者其血浆中的proBNP,cTNI和CK-MB水平及APACHE Ⅱ评分均高于存活组患者(均P<0.05),差异有统计学意义;严重脓毒症组患者血浆proBNP 水平与cTnI及CK-MB水平呈正相关性(P<0.05); 血浆proBNP水平、cTnI水平、CK-MB水平分别与APACHEⅡ评分呈正相关性(P<0.05)。结论 血浆proBNP 及cTnⅠ水平可有效反映老年脓毒症患者心肌受损程度,早期血浆proBNP、cTnI、CK-MB水平联合检测对老年脓毒症患者预后判断可能有重要临床意义。

关键词: 脓毒症, 脑利钠肽前体, 肌钙蛋白Ⅰ, 磷酸肌酸激酶MB同工酶

Abstract: Objective To study the clinical significance of cardiac injury biomarkers(CK-MB and cTnI) and pro-brain natriuretic peptide(proBNP) joint detection for prognosis value in Elderly sepsis. Methods Sixty elderly patients with sepsis were selected. According to the severity of disease divided into general and severe sepsis group.Meanwhile, 30 healthy volunteers as a control group. Comparative study of plasma proBNP, cTnI, CK-MB levels and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) in three groups;and the correlation analysis of the indicators. Results Compared with control group, the plasma levels of proBNP and cTnI were significantly higher in patients with sepsis; And the APACHEⅡ score in the severe sepsis group was significantly higher than the general sepsis group (P<0. 05). The plasma proBNP, cTnI, CK-MB level and APACHE Ⅱ scores in death group were significantly higher than the survival group (P<0. 05). The proBNP plasma levels, cTnⅠ and CK-MB levels in severe sepsis patients were positively correlated (P<0. 05); They were positively correlated between ProBNP level, cTnⅠ level and the APACHEⅡ score(P<0. 05). Conclusions ProBNP plasma levels and cTnⅠ can effectively reflect the extent of the cardiac damage in elderly sepsis; Early plasma proBNP level, cTnI and CK-MB combined detection of elderly sepsis may have important clinical significance.

Key words: Sepsis, pro-brain natriuretic peptide, Troponin I, Creatine kinase MB