摘要
目的探讨N末端B型利钠肽原(NT-proBNP)与红细胞压积(HCT)对脓毒症患者心肌损伤的诊断价值。方法前瞻性选择2017年2月至2019年11月于延安大学附属医院ICU病房进行诊治的脓毒症患者108例为研究对象,根据心肌损伤情况进行分组。检测心肌损伤组和非心肌损伤组的肾功能指标[血肌酐(Scr)、尿素氮(BUN)]和心肌酶指标[血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]含量,血清NT-proBNP与HCT值等。分析脓毒症患者心肌损伤与NT-proBNP、HCT等指标的相关性。结果108例患者中,发生心肌损伤36例(损伤组),发生率为33.3%。损伤组的Scr、BUN、CK、CK-MB、LDH含量分别为(174.20±22.75)μmol/L、(26.10±3.29)μmol/L、(250.14±32.49)U/L、(23.08±4.82)U/L、(192.84±25.10)U/L,均显著高于非损伤组[(131.48±24.88)μmol/L、(15.20±3.11)μmol/L、(154.09±20.44)U/L、(15.00±2.77)U/L、(95.29±11.83)U/L],差异有统计学意义(P<0.05)。损伤组的NT-proBNP与HCT水平分别为(46.66±5.44)ng/mL、(37.41±1.44)%,均显著高于非损伤组[(27.83±2.11)ng/mL、(30.66±1.11)%],差异有统计学意义(P<0.05)。Spearman相关分析显示,心肌损伤与CK、CK-MB、LDH、NT-proBNP、HCT均存在相关性(r=0.544、0.482、0.421、0.389、0.672,P<0.05)。Logistic回归分析显示,CK、CK-MB、LDH、NT-proBNP、HCT为导致心肌损伤发生的影响因素(P<0.05)。结论脓毒症患者心肌损伤比较常见,多伴随有NT-proBNP高表达与HCT增加情况,NT-proBNP、HCT为导致脓毒症患者发生心肌损伤的影响因素。
Objective To explore the diagnostic values of N-terminal pro-brain natriuretic peptide(NT-proBNP)and hematocrit(HCT)on myocardial injury in patients with sepsis.Methods From February 2017 to November 2019,108 cases of patients with sepsis were selected for diagnosis and treatment in the ICU ward of Affiliated Hospital of Yan'an University.All patients were detected with NT-proBNP and HCT.The clinical data of the patients were investigated,were to determine the occurrence of myocardial injury and given correlation analysis.Results There were 36 cases were myocardial injury(injury group)in the 108 cases,and the incidence were 33.3%.The contents of Scr,BUN,CK,CK-MB and LDH in the injured group were(174.20±22.75)μmol/L,(26.10±3.29)μmol/L,(250.14±32.49)U/L,(23.08±4.82)U,respectively/L,(192.84±25.10)U/L respectively,which were significantly higher than the non-injury group[(131.48±24.88)μmol/L,(15.20±3.11)μmol/L,(154.09±20.44)U/L,(15.00±2.77)U/L,(95.29±11.83)U/L],the difference was statistically significant(P<0.05).The NT-proBNP and HCT levels of the injury group were(46.66±5.44)ng/mL and(37.41±1.44)%respectively,which were significantly higher than those of the non-injury group[(27.83±2.11)ng/mL,(30.66±1.11)%],the difference was statistically significant(P<0.05).Spearman correlation analysis showed that myocardial injury were associated with CK,CK-MB,LDH,NT-proBNP,and HCT(r=0.544,0.482,0.421,0.389,0.672,P<0.05).Logistic regression analysis showed that CK,CK-MB,LDH,NT-proBNP,and HCT were the influencing factors of myocardial injury(P<0.05).Conclusion Myocardial injury in patients with sepsis are relatively common,and were mostly accompanied by high expression of NT-proBNP and increased HCT.NT-proBNP and HCT are influencing factors for myocardial injury in patients with sepsis.
作者
贺芬
郑艳妮
沙海旺
袁伟伟
李玲霞
HE Fen;ZHENG Yan-ni;SHA Hai-wang(Surgical Intensive Care Center,Affiliated Hospital of Yan'an University,Yan'an Shaanxi 716000,China)
出处
《临床和实验医学杂志》
2020年第20期2150-2153,共4页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金项目(编号:81760069)
陕西省社会发展科技攻关项目(编号:2016SF-075)。
关键词
脓毒症
心肌损伤
N末端B型利钠肽原
红细胞压积
相关性
Sepsis
Myocardial injury
N-terminal pro-B-type natriuretic peptide
Hematocrit
Correlation
