【摘要】 目的探讨血浆脑利钠肽前体(pro BNP)和心肌损伤标志物(CK-MB和c Tn I)联合检测对老年脓毒症患者心肌损伤及预后评估的临床意义。方法选择60例老年脓毒症患者按病情严重程度分为一般脓毒症组和严重脓毒症组,另选取同期在我院行健康体检的同龄人30例作为对照组。比较三组和不同预后患者血浆pro BNP、c TNI、CK-MB水平及急性生理和慢性健康状态评分Ⅱ(APACHEⅡ),并对各指标进行相关性分析。结果脓毒症患者血浆pro BNP、c Tn I水平高于对照组,且严重脓毒症组APACHEⅡ评分高于一般脓毒症组(均P<0.05);死亡组患者其血浆中的pro BNP,c TNI和CK-MB水平及APACHEⅡ评分均高于存活组患者(均P<0.05),差异有统计学意义;严重脓毒症组患者血浆pro BNP水平与c Tn I及CK-MB水平呈正相关性(P<0.05);血浆pro BNP水平、c Tn I水平、CKMB水平分别与APACHEⅡ评分呈正相关性(P<0.05)。结论血浆pro BNP及c TnⅠ水平可有效反映老年脓毒症患者心肌受损程度,早期血浆pro BNP、c Tn I、CK-MB水平联合检测对老年脓毒症患者预后判断可能有重要临床意义。更多还原

【Abstract】 Objective To study the clinical significance of cardiac injury biomarkers( CK-MB and c Tn I) and probrain natriuretic peptide( pro BNP) joint detection for prognosis value in Elderly sepsis. Methods Sixty elderly patients with sepsis were selected. According to the severity of disease divided into general and severe sepsis group. Meanwhile,30 healthy volunteers as a control group. Comparative study of plasma pro BNP,c Tn I,CK-MB levels and acute physiology and chronic health evaluation Ⅱ( APACHE Ⅱ) in three groups; and the correlation analysis of the indicators. Results Compared with control group,the plasma levels of pro BNP and c Tn I were significantly higher in patients with sepsis; And the APACHEⅡ score in the severe sepsis group was significantly higher than the general sepsis group( P < 0. 05). The plasma pro BNP,c Tn I,CK-MB level and APACHE Ⅱ scores in death group were significantly higher than the survival group( P < 0. 05). The pro BNP plasma levels,c TnⅠ and CK-MB levels in severe sepsis patients were positively correlated( P < 0. 05); They were positively correlated between Pro BNP level,c TnⅠ level and the APACHEⅡ score( P < 0. 05). Conclusions Pro BNP plasma levels and c TnⅠcan effectively reflect the extent of the cardiac damage in elderly sepsis; Early plasma pro BNP level,c Tn I and CK-MB combined detection of elderly sepsis may have important clinical significance.更多还原