CAJ | 학술논문

目的：探讨重症脓毒症和脓毒症休克患者心脏损伤指标的临床价值。方法入选2009年12月至2013年6月德阳市第二人民医院重度脓毒症患者44例和脓毒症休克患者40例,分别记作S组和SS组,依据患者心功能情况和存活情况,每组再分为心功能正常组( n)、心功能异常组( a)；存活组(s)、死亡组(d),其中Sn组25例(56．8%),Sa组19例(43．2%)；Ss组31例(70．5%),Sd组13例(29．5%)；SSn组17例(42．5%),SSa组23例(57．5%)；SSs组11例(27．5%),SSd组29例(72．5%)。测定各组患者入院第1、3和7日的脑钠肽、肌钙蛋白I和肌钙蛋白T水平,探讨临床价值。结果 S组和SS组各时点脑钠肽和肌钙蛋白I水平差异均无统计学意义,但SS组各时点肌钙蛋白T水平显著高于S组,Sa组、Ssa组、Sd组和SSd组各时点脑钠肽、肌钙蛋白T和肌钙蛋白I水平均分别显著高于Sn组、SSn组、Ss组和SSs组,差异均有统计学意义(均P<0．05)。结论脑钠肽、肌钙蛋白T和肌钙蛋白I水平可以反映脓毒症休克和重度脓毒症患者的心脏损伤程度,脑钠肽、肌钙蛋白T和肌钙蛋白I水平高者死亡率高、预后差。
목적：탐토중증농독증화농독증휴극환자심장손상지표적림상개치。방법입선2009년12월지2013년6월덕양시제이인민의원중도농독증환자44례화농독증휴극환자40례,분별기작S조화SS조,의거환자심공능정황화존활정황,매조재분위심공능정상조( n)、심공능이상조( a)；존활조(s)、사망조(d),기중Sn조25례(56．8%),Sa조19례(43．2%)；Ss조31례(70．5%),Sd조13례(29．5%)；SSn조17례(42．5%),SSa조23례(57．5%)；SSs조11례(27．5%),SSd조29례(72．5%)。측정각조환자입원제1、3화7일적뇌납태、기개단백I화기개단백T수평,탐토림상개치。결과 S조화SS조각시점뇌납태화기개단백I수평차이균무통계학의의,단SS조각시점기개단백T수평현저고우S조,Sa조、Ssa조、Sd조화SSd조각시점뇌납태、기개단백T화기개단백I수평균분별현저고우Sn조、SSn조、Ss조화SSs조,차이균유통계학의의(균P<0．05)。결론뇌납태、기개단백T화기개단백I수평가이반영농독증휴극화중도농독증환자적심장손상정도,뇌납태、기개단백T화기개단백I수평고자사망솔고、예후차。
Objective To investigate the clinical value of severe sepsis and septic shock in patients with cardiac injury index. Methods From Dec. 2009 to Jun. 2013 in Deyang Second People′s Hospital 40 patients with severe sepsis and 40 patients with septic shock were included in the study,denoted as S group and SS Group,and on the basis of the heart function and the survival condition of the patients,each group was further divided into normal heart function group( n) ,abnormal cardiac function group( a) ,survival group( s) and death group(d),including 25 cases(56. 8%) in Sn group,19 cases(43. 2%) in Sa group,31 cases (70.5%) in Ss group,13 cases(29. 5%) in Sd group;17 cases (42. 5%) in SSn group,23 cases (57. 5%) in SSa group,11 cases(27. 5%) in SSs group,29 cases(72. 5%) in SSd group. Brain natriuretic peptide(BNP),troponin I(TnI) and troponin T(TnT) levels of the patients at the 1st,3rd,and 7th day of admission were tested to explore the clinical value. Results There was no significant difference of BNP and TnI level between S group and SS group at different time points,but in SS group TnT was higher than that in S group,BNP,TnT and TnI levels of Sa group,SSa group,Sd group and SSd group at different time points were significantly higher than those in Sn group,SSn group,Ss group and SSs group,the differences had sta-tistical significance (all P <0. 05). Conclusion BNP,TnT and TnI levels can reflect the heart damage degree of septic shock and severe sepsis patients,BNP,TnT and TnI levels are associated with high mortality and poor prognosis.