早期心肌肌钙蛋白I及乳酸水平联合检测对急诊老年严重脓毒症及脓毒症休克患者预后的评估价值

摘要

Objective To explore value of early detection of cardiac troponin I(cTnI) and lactate in evaluating prognosis of emergency elderly patients with severe sepsis and septic shock.Methods A total of 98 elderly patients with severe sepsis oRseptic shock were selected.The patients were divided into survival group and death group according to the prognosis with follow-up of 28 d.The levels of cTnI,lactate,APACHE Ⅱ score and SOFA score were compared between different groups.The correlation analysis was performed between cTnI,lactate and APACHE Ⅱ score,SOFA score.Results The level of lactate and cTnI,APACHE Ⅱ score and SOFA score in septic shock group were significantly higheRthan those in severe sepsis patients,and the level of lactate,cTnI,APACHE Ⅱ score and SOFA score in death group were significantly greateRthan those in survival group (P<0.05).The level of lactate and cTnI showed a certain correlation with APACHE Ⅱ score and SOFA score (P<0.05).The areas undeRthe ROC curve of cTnI and arterial blood lactate were 0.846 and 0.809 respectively.Conclusion The cTnI and arterial blood lactate can evaluate condition and prognosisof emergency elderly patients with severe sepsis and sepsis shock.%目的 研究早期血浆心肌肌钙蛋白I(cTnI)及动脉血乳酸水平联合检测对老年严重脓毒症及脓毒性休克患者病情和预后的评估价值.方法 收集急诊老年严重脓毒症和脓毒性休克患者98例.随访28 d,根据患者预后分为死亡组和存活组,比较死亡组和存活组cTnI、乳酸、APACHEⅡ评分及SOFA评分.比较脓毒性休克和严重脓毒症组的cTnI、乳酸、APACHEⅡ评分及SOFA评分.进行cTnI,乳酸与APACHEⅡ评分、SOFA评分的相关性分析.结果 脓毒性休克组患者cTnI、乳酸、APACHEⅡ评分和SOFA评分大于严重脓毒症组,死亡组cTnI和乳酸均大于存活组(P<0.05).cTnI、乳酸水平与APACHEⅡ评分、SOFA评分具有显著相关性(P<0.05),cTnI、乳酸预测死亡ROC曲线下面积分别为0.846、0.809(P<0.05).结论 cTnI和动脉血乳酸联合检测对急诊老年严重脓毒症和脓毒性休克患者的病情和预后具有重要的评估价值.