摘要
目的 探讨超声心动图参数联合肌钙蛋白I(cTnI)对重症肺炎(SP)患者心肌损伤的评估价值。方法 选取2021年3月至2023年3月唐山市弘慈医院收治的65例SP合并心肌损伤患者作为合并心肌损伤组、41例单纯SP患者作为单纯SP组,另外选取同时期在本院进行体检的120名健康人作为对照组。比较三组超声心动图参数、cTnI水平;采用受试者工作特性(ROC)曲线评估超声心动图参数、cTnI对SP患者心肌损伤的预测价值;采用多因素Logistic回归分析探讨SP患者心肌损伤的影响因素。结果LVEF水平:对照组>单纯SP组>合并心肌损伤组,LVEDD、LVESD、cTnI水平:对照组<单纯SP组<合并心肌损伤组,差异有统计学意义(P<0.05)。超声心动图参数、cTnI及两者联合预测SP患者心肌损伤的曲线下面积(AUC)95%置信区间(CI)分别为0.755(0.704~0.807)、0.859(0.808~0.911)、0.904(0.853~0.956)。合并心肌损伤组合并糖尿病占比、合并低钾血症占比、发病至入院时间≥1周占比大于单纯SP组,CRP、WBC、PCT、CK-MB水平高于单纯SP组,差异有统计学意义(P<0.05)。合并糖尿病(OR=2.085,95%CI:1.429~3.044)、PCT水平升高(OR=2.385,95%CI:1.598~3.578)、LVEF水平降低(OR=0.367,95%CI:0.238~0.566)、cTnI水平升高(OR=3.377,95%CI:2.135~5.342)是SP患者心肌损伤的独立危险因素(P<0.05)。结论 超声心动图参数、cTnI对SP患者心肌损伤具有一定的预测价值,且两者联合预测的效能更好。
Objective To investigate the value of echocardiographic parameters combined with troponin I(cTnI)in evaluating myocardial injury in patients with severe pneumonia(SP).Methods 65 pa⁃tients with SP combined with myocardial injury who were admitted to Hongci Hospital in Tangshan City from March 2021 to March 2023 were selected as the combined myocardial injury group.Additionally,41 patients with simple SP were chosen as the simple SP group.Furthermore,120 healthy individuals who underwent physical examinations at our hospital during the same period were selected as the control group.Three groups of echocardiography parameters and cTnI levels were compared.The predictive value of echocardiography pa⁃rameters and cTnI for myocardial injury in SP patients were evaluated using receiver operating characteristic(ROC)curves.The influencing factors of myocardial injury in SP patients were assessed using multiple logis⁃tic regression analysis.Results LVEF levels:control group>simple SP group>combined myocardial injury group,LVEDD,LVESD,cTnI levels:control group<simple SP group<combined myocardial injury group,the difference was statistically significant(P<0.05).The area under the curve(AUC)of echocardiog raphy parameters,cTnI,and their combined prediction for myocardial injury in SP patients have a 95%confi⁃dence interval(CI)of 0.755(0.704~0.807),0.859(0.808~0.911),and 0.904(0.853~0.956),respectively.The ratio of diabetes combined with myocardial injury,hypokalemia,and the time from onset to admission≥1 week were higher than those of SP group alone,and the levels of CRP,WBC,PCT,CK⁃MB were higher than those of SP group alone,with statistical significance(P<0.05).Diabetes(OR=2.085,95%CI:1.429~3.044),increased PCT level(OR=2.385,95%CI:1.598~3.578),decreased LVEF level(OR=0.367,95%CI:0.238~0.566),and increased cTnI level(OR=3.377,95%CI:2.135~5.342)were independent risk factors for myocardial injury in SP patients(P<0.05).Conclusion Echocardiographic parameters and cTnI have a cer⁃tain value in predicting myocardial
作者
于立新
崔玉祥
窦萍
袁晓亮
YU Lixin;CUI Yuxiang;DOU Ping;YUAN Xiaoliang(Department of Ultrasound,Tangshan Hongci Hospital,Tangshan,Hebei,China,063000;Department of Cardiology,Tangshan Hongci Hospital,Tangshan,Hebei,China,063000)
出处
《分子诊断与治疗杂志》
2024年第7期1341-1344,1349,共5页
Journal of Molecular Diagnostics and Therapy
基金
中国金属学会冶金安全与健康分会健康卫生科研项目(jkws202373)。
关键词
重症肺炎
心肌损伤
超声心动图参数
肌钙蛋白Ⅰ
Severe pneumonia
Myocardial injury
Echocardiographic parameters
TroponinⅠ
