中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
10期
36-39
,共4页
脓毒症%休克%心肌损伤
膿毒癥%休剋%心肌損傷
농독증%휴극%심기손상
Sepsis%Shock%Myocardium injury
目的 探讨心肌肌钙蛋白Ⅰ(cTnI)、脑钠尿肽(BNP)、血乳酸、急性生理和慢性健康评估(APACHE)Ⅱ评分在脓毒症休克患者中判断心肌损伤程度及预后的价值.方法 确诊脓毒症休克患者61例,入院后即刻,治疗后6,24h检测血乳酸、BNP、cTnI水平,并进行APACHEⅡ评分,观察存活组和死亡组上述指标差异.结果 61例患者中35例存活(存活组),26例死亡(死亡组).死亡组入院后即刻BNP、cTnI、血乳酸、APACHEⅡ评分均明显高于存活组,差异有统计学意义(P＜0.05).死亡组治疗后6h上述指标与入院后即刻比较差异无统计学意义(P＞0.05),治疗后24 h上述指标显著高于入院后即刻,差异有统计学意义(P＜0.05).存活组治疗后6,24h上述指标均较入院后即刻明显降低,且治疗后24 h上述指标均较治疗后6h也明显降低[BNP:(478.1±95.3) ng/L比(1025.2±263.3) ng/L;cTnI:(0.9±0.1) μg/L比(2.5±0.4)μg/L;血乳酸:(2.4±0.3) mmol/L比(5.4±2.1) mmol/L; APACHEⅡ评分:(11.4±1.8)分比(15.6±2.9)分],差异均有统计学意义(P＜0.05).结论 BNP、cTnI、血乳酸、APACHEⅡ评分可反映脓毒症休克患者心肌损伤的严重程度,预测患者预后.
目的 探討心肌肌鈣蛋白Ⅰ(cTnI)、腦鈉尿肽(BNP)、血乳痠、急性生理和慢性健康評估(APACHE)Ⅱ評分在膿毒癥休剋患者中判斷心肌損傷程度及預後的價值.方法 確診膿毒癥休剋患者61例,入院後即刻,治療後6,24h檢測血乳痠、BNP、cTnI水平,併進行APACHEⅡ評分,觀察存活組和死亡組上述指標差異.結果 61例患者中35例存活(存活組),26例死亡(死亡組).死亡組入院後即刻BNP、cTnI、血乳痠、APACHEⅡ評分均明顯高于存活組,差異有統計學意義(P＜0.05).死亡組治療後6h上述指標與入院後即刻比較差異無統計學意義(P＞0.05),治療後24 h上述指標顯著高于入院後即刻,差異有統計學意義(P＜0.05).存活組治療後6,24h上述指標均較入院後即刻明顯降低,且治療後24 h上述指標均較治療後6h也明顯降低[BNP:(478.1±95.3) ng/L比(1025.2±263.3) ng/L;cTnI:(0.9±0.1) μg/L比(2.5±0.4)μg/L;血乳痠:(2.4±0.3) mmol/L比(5.4±2.1) mmol/L; APACHEⅡ評分:(11.4±1.8)分比(15.6±2.9)分],差異均有統計學意義(P＜0.05).結論 BNP、cTnI、血乳痠、APACHEⅡ評分可反映膿毒癥休剋患者心肌損傷的嚴重程度,預測患者預後.
목적 탐토심기기개단백Ⅰ(cTnI)、뇌납뇨태(BNP)、혈유산、급성생리화만성건강평고(APACHE)Ⅱ평분재농독증휴극환자중판단심기손상정도급예후적개치.방법 학진농독증휴극환자61례,입원후즉각,치료후6,24h검측혈유산、BNP、cTnI수평,병진행APACHEⅡ평분,관찰존활조화사망조상술지표차이.결과 61례환자중35례존활(존활조),26례사망(사망조).사망조입원후즉각BNP、cTnI、혈유산、APACHEⅡ평분균명현고우존활조,차이유통계학의의(P＜0.05).사망조치료후6h상술지표여입원후즉각비교차이무통계학의의(P＞0.05),치료후24 h상술지표현저고우입원후즉각,차이유통계학의의(P＜0.05).존활조치료후6,24h상술지표균교입원후즉각명현강저,차치료후24 h상술지표균교치료후6h야명현강저[BNP:(478.1±95.3) ng/L비(1025.2±263.3) ng/L;cTnI:(0.9±0.1) μg/L비(2.5±0.4)μg/L;혈유산:(2.4±0.3) mmol/L비(5.4±2.1) mmol/L; APACHEⅡ평분:(11.4±1.8)분비(15.6±2.9)분],차이균유통계학의의(P＜0.05).결론 BNP、cTnI、혈유산、APACHEⅡ평분가반영농독증휴극환자심기손상적엄중정도,예측환자예후.
Objective To explore the value of cardiac troponin Ⅰ (cTnI),brain natriuretic peptide (BNP),blood lactate and acute physiology and chronic health evaluation (APACHE) Ⅱ score which used to evaluate the severity of sepsis shock patients with myocardium injury.Methods Data of 61 patients with sepsis shock were collected,and cTnI,BNP,blood lactate were monitored and APACHE Ⅱ score were scored at admission,6,24 h after treatment.All of these indicators were compared between death group and survival group.Results In 61 patients,35 cases of them were lived (survival group),26 cases of them were died (death group).The cTnI,BNP,blood lactate and APACHE Ⅱ score at admission in death group was significantly higher than that in survival group (P＜ 0.05).In death group all of these indicators there was no significantly difference between admission and 6 h after treatment (P ＞0.05);24 h after treatment was significantly higher than that 6 h after treatment (P ＜ 0.05).In survival group 6,24 h after treatment was significantly lower than that at admission,24 h after treatment was significantly lower than that 6 h after treatment [BNP:(478.1 ± 95.3)ng/L vs.(1 025.2 ± 263.3) ng/L,cTnI:(0.9 ± 0.1) μ g/L vs.(2.5 ± 0.4) μ g/L,blood lactate:(2.4 ± 0.3) mmol/L vs.(5.4 ± 2.1) mmol/L,APACHE Ⅱ score:(11.4 ± 1.8) scores vs.(15.6 ± 2.9) scores] (P ＜ 0.05).Conclusion BNP,cTnI,blood lactate and APACHE Ⅱ score may be used to evaluate the severity of sepsis shock patients with myocardium injury and predict outcome of the patients.
