摘要
目的探究血乳酸、心肌酶谱、高敏心肌肌钙蛋白(hs⁃cTnT)对体外循环心脏手术患者预后的影响。方法分析2018年6月到2022年12月150例于安徽省六安世立医院行体外循环心脏手术的患者,收集患者的相关资料,根据患者随访的预后情况,将患者分为预后良好组(n=113)和预后不良组(n=37)。分析影响患者预后的相关因素,对比不同预后患者术后的血乳酸、心肌酶谱[肌酸激酶同工酶(CK⁃MB)、肌酸激酶(CK)]、hs⁃cTnT变化,采用受试者工作曲线(ROC)分析血乳酸、心肌酶谱、hs⁃cTnT对外循环心脏手术患者预后的评估价值。结果预后不良组患者的血清血乳酸、CK⁃MB、CK、hs⁃cTnT水平明显高于预后良好组,差异具有统计学意义(t=3.909,5.260,3.475,6.093;P<0.05)。单因素分析结果显示,年龄、体外循环时间、心瓣膜病、冠心病是体外循环心脏手术患者预后的影响因素(t=5.182,4.424,29.996;P<0.05)。多因素分析结果显示,年龄、体外循环时间、冠心病是体外循环心脏手术患者预后的影响因素(P<0.05)。ROC曲线分析结果显示,SLL、CK⁃MB、CK、hs⁃cTnT水平评估体外循环心脏手术患者预后的曲线下面积分别为0.739、0.837、0.732、0.821,而四者联合预测的曲线下面积为0.923,高于单一检测(P<0.05)。结论年龄、体外循环时间、冠心病是体外循环心脏手术患者预后的影响因素,血乳酸、心肌酶谱、hs⁃cTnT评估患者预后具有较高的价值。
Objective To explore the influence of lactic acid,myocardial enzymes and hs⁃cTnT on the prognosis of patients undergoing cardiac surgery under cardiopulmonary bypass.Methods From June 2018 to December 2022,150 patients who underwent heart surgery under cardiopulmonary bypass in Liuan City Hospital,Anhui Province were retrospectively analyzed,and the relevant data of patients were collected.According to the prognosis of patientsfollow⁃up,patients were divided into the good prognosis group(n=113)and the poor prognosis group(n=37).To analyze the related factors affecting the prognosis of patients,the changes of blood lactic acid,myocardial enzymes(CK⁃MB,CK)and hs⁃cTnT in patients with different prognosis after operation were compared,and the evaluation value of blood lactic acid,myocardial enzymes and hs⁃cTnT in patients undergoing open heart surgery with ROC curve was analyzed.Results The levels of serum lactic acid,CK⁃MB,CK,and hs⁃cTnT in patients with poor prognosis were significantly higher than those in patients with good prognosis(t=3.909,5.260,3.475,6.093;P<0.05).Univariate analysis showed that age,cardiopulmonary bypass time,valvular heart disease and coronary heart disease were the influencing factors of prognosis in patients undergoing cardiopulmonary bypass(t=5.182,4.424,29.996;P<0.05).Multi⁃variate analysis showed that age,cardiopulmonary bypass time and coronary heart disease were the influencing factors for the prognosis of patients undergoing cardiac surgery under cardiopulmonary bypass(P<0.05).The results of ROC curve analysis showed that the areas under the curve of SLL,CK⁃MB,CK and hs⁃cTnT levels in evaluating the prognosis of patients undergoing cardiac surgery with cardiopulmonary bypass were 0.739,0.837,0.732 and 0.821,respectively,while the area under the curve of the combined prediction of the four in⁃dicators was 0.923,which was higher than that of single detection.Conclusion Age,cardiopulmonary by⁃pass time and coronary heart disease are the influencing factor
作者
黄慧
张良
赵刚
刘宝
王琴琴
许成
王成洋
HUANG Hui;ZHANG Liang;ZHAO Gang;LIU Bao;WANG Qinqin;XU Cheng;WANG Chengyang(Cardiac Intensive Care Unit,Liu'an Shi Li Hospital,Lu'an,Anhui,China,237000)
出处
《分子诊断与治疗杂志》
2023年第9期1650-1653,共4页
Journal of Molecular Diagnostics and Therapy
基金
安徽省中医药传承创新科研(2022CCZDO8)。
关键词
血乳酸
心肌酶谱
高敏心肌肌钙蛋白
体外循环心脏手术
Serum lactate level
Myocardial enzymes
High sensitivity cardiac troponin
Cardio⁃pulmonary bypass heart surgery
