脓毒症患者血清超敏肌钙蛋白水平与其预后的关系

摘要

Objective: To investigate the relationship between level of high-sensitive troponin 1 (hs-TnI) and prognosis in patients of sepsis. Method: 112 patients of sepsis were collected and divided into normal hs-TnI group and high hs-TnI group according to their serum hs-TnI level within 1 hr after hospitalization. APACHE H scores were tested within 24 hours after hospitalization. Correlation between APACHE Ⅱ and hs-TnI was analyzed in high hs-TnI group, distributions of other illness and AK1, usage of vasopressors, mechanical ventilation( MV) , continuous renal replacement therapy (CRRT) aimed at AK1, length of hospitalization and stay in ICU, hospital motality and 1CU mortality were compared between the two groups. Results: More complications and high incidence of AK1 were observed in high hs-TnI group than in normal hs-TnI level(P＜0. 01). The level of hs-TnI was correlated positively with APACHE H score in these patients with high serum hs-TnI(r2 = 0. 5958, P＜0. 01). There was no difference of usage of mechanical ventilation and vasopressors between the two groups(P＞0. 05) , but the time of MV and therapy of vasopressors were longer in high hs-TnI group than in normal hs-TnI level(F ＜0. 05 or P＜0. 01). Length of hospital stay and ICU stay were both longer in patients of high hs-TnI group compared with those of normal hs-TnI group(P＜0. 05). Hospital mortality and ICU mortality increased significantly in patients with high level of hs-TnI(P＜0. 05). Conclusion: Serum hs-TnI may help to evaluate prognosis of patients with sepsis, higher level of serum hs-TnI, worse prognosis.%目的:探讨血清超敏肌钙蛋白(hs-TnI)水平与脓毒症患者预后的关系.方法:脓毒症患者112例,入院1h内检测hs-TnI水平,并将其分为hs-TnI正常组和hs-TnI升高组;入院24h内进行APACHEⅡ评分.分析hs-TnI升高组hs-TnI水平与APACHEⅡ评分的相关性;比较两组患者基础疾病和并发症急性肾损伤(AKI)分布;比较两组患者升压药、机械通气及针对AKI的连续性肾脏替代治疗(CRRT)的使用率和使用时间;比较两组总住院时间、住ICU时间和住院死亡率、ICU死亡率.结果:hs-TnI升高组基础疾病比例和AKI发生率显著高于hs-TnI正常组(P<0.01).Hs-TnI水平升高患者APACHEⅡ评分也升高,两者呈显著正相关(r2=0.5958,P<0.01).两组机械通气和升压药使用率无显著性差异(P>0.05),hs-TnI升高组机械通气和升压药治疗时间显著长于hs-TnI正常组(P<0.05或P<0.01),针对AKI的CRRT使用率高于hs-TnI正常组(P<0.05);hs-TnI升高组患者的总住院时间、住ICU时间、住院死亡率和ICU死亡率显著高于hs-TnI正常组(P<0.05).结论:hs-TnI升高有助于判断脓毒症患者预后,hs-TnI水平越高,预后越差.