摘要
目的探讨血清肌钙蛋白Ⅰ(cardiactroponinI,cTnI)升高与急诊创伤患者死亡率之间的关系。方法回顾性分析2014年1月至2018年10月航天中心医院收治的293例创伤患者的临床资料,将其分为存活组266例和死亡组27例;比较两组损伤严重程度评分(injury seventy score,ISS)与cTnI值的差异;同时依据ISS的结果将患者分为轻度创伤组(≤16分)267例、中度创伤组(16～25分)21例、重度创伤组(>25分)5例,记录患者28天死亡率,比较轻度创伤组、中度创伤组及重度创伤组cTnI与死亡率的关系,并通过受试者工作特征(ROC)曲线评估cTnI对急诊创伤患者预后的意义。结果死亡组ISS评分及cTnI值明显高于存活组,差异有显著性(P<0.05)。轻度创伤组、中度创伤组及重度创伤组死亡率及cTnI值差异有显著性(P<0.05);随着cTnI值的增加,死亡率也呈上升趋势;急诊创伤患者cTnI值与ISS评分呈正相关(r=0.784,P<0.01);绘制ROC曲线,计算cTnI曲线下面积(AUC)为0.776(95%CI:0.691～0.862),对急诊创伤患者的预后具有中等预测价值。ISS评分AUC为0.717(95%CI:0.637～0.797),联合ISS评分与cTnI值AUC为0.792(95%CI:0.716～0.867),高于二者单独预后诊断价值。结论创伤患者cTnI水平与死亡率相关,可以成为急诊创伤死亡率的预测因子。
Objective To investigate the relationship between cardiac troponin I(cTnI) elevation and mortality of emergency trauma patients. Method The clinical data of 293 patients with trauma admitted to Aerospace Center Hospital from January 2014 to October 2018 were retrospectively analyzed. According to the results of injury seventy score(ISS) score, the patients were divided into mild trauma group, moderate trauma group and severe trauma group. The fatality rate of 28 days was recorded by outcome indicators. To compare the relationship between cTnI and mortality in different groups, and to evaluate the prognostic significance of cTnI in emergency trauma patients by ROC curve. Result ISS score and cTnI value in the death group were significantly higher than those in the survival group (P<0. 05). There were significant differences in mortality and cTnI among patients with different scores (P< 0. 05). With the increase of cTnI value, the mortality rate also showed an upward trend. Pearson correlation analysis showed that cTnI were positively correlated with ISS score in emergency trauma patients (r =0. 784, P<0. 01). The area under the cTnI curve (AUC) was 0. 776, which had a moderate predictive value for the prognosis of patients with emergency trauma. The AUC was 0. 717(95% CI:0. 637 ~0. 797)for ISS score. While the AUC was 0. 792(95% CI:0. 716 ~0. 867)for combined value of ISS score and cTnI, which was higher than their predictive value for the prognosis alone. Conclusion The level of cTnI in traumatic patients is correlated with mortality, and can be used as a predictor of emergency trauma mortality.
作者
张海滨
史海娜
王旭东
ZHANG Hai-bin;SHI Hai-na;WANG Xu-dong(Emergency Department,Aerospace Center Hospital,Beijing 100049, China)
出处
《中国临床医生杂志》
2019年第6期661-663,共3页
Chinese Journal For Clinicians
基金
中国航天科工项目(KYLX-083)
