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肌钙蛋白Ⅰ在脓毒性休克致左心室舒张功能障碍患者中的变化和意义 预览 被引量:2

Significance of Troponin-I in patients with septic shock and left ventricular diastolic dysfunction
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摘要 目的:探讨脓毒性休克致左心室舒张功能障碍患者肌钙蛋白Ⅰ(cTnI)的变化及临床价值。方法:回顾性分析重症医学科(ICU)收治的脓毒性休克致左心室舒张功能障碍患者38例(Sa组),脓毒性休克心功能正常患者20例(Sn组),未诊断脓毒性休克但发生左心室舒张功能障碍患者20例作为对照组(Ca组),于入ICU72h内应用超声心动图通过测定二尖瓣舒张早期峰流速与二尖瓣环舒张早期运动速度比值(E/e’)评估心脏舒张功能,同时检测cTnI。比较各组cTnI水平差异及其与E/e’相关性。绘制受试者工作者特征曲线(ROC),评估cTnI预测脓毒性休克患者致左心室舒张功能障碍发生的价值。结果:Sa组、Sn组的cTnI水平均较Ca组明显增高(P〈0.05);Sa组cTnI水平、E/e’明显高于Sn组(P〈0.05)。cTnI与E/e’呈正相关(r=0.367,P=0.004)。ROC显示cTnI为0.49ng/mL时预测脓毒性休克致左心室舒张功能障碍发生的曲线下面积为0.834,敏感度为77.6%,特异度为80.7%。结论:脓毒性休克患者cTnI水平明显升高,cTnI升高与脓毒性休克致左心室舒张功能障碍密切相关,cTnI≥0.49ng/mL可有效预测脓毒性休克致左心舒张功能障碍的发生。 Objective To investigatethe clinical value of troponin-I (cTnI) in patientswith septic shockand left ventricular diastolic dysfunction. Methods As a retrospective analysis, 38 patients with left ventricular diastolic dysfunction and septic shock (Sa group) , as well as 20 patients with normal cardiac function (Sn group) were enrolled in this study. Moreover, 20 patients with left ventricular diastolic dysfunction and without septic shock were used as control group (Ca group). The ratio of early diastolic mitral inflow velocity tO early diastolic mitral annulus velocity (E/e') was measured as the evaluation index of left ventricular diastolicfunction by echocardiography within 72 hours after admission to ICU. Level of cTnI was detected in all cases and the relationship was evaluated by E/e'. Receiver operating characteristic curve (ROC) was constructed to indicate the predictable value of left ventricular diastolic dysfunction in patients with septic shock. Results The level of cTnI was significantly elevated in both Sa group and Sn group (P 〈 0.05 ), while the level of cTnI and E/e' in Sa group were significantly higher than those in Sn group (P 〈 0.05 ). eTnI was positively correlated with E/e' (r = 0.367, P = 0.004). The area under the curve (AUC) of cTnI was 0.834, with the cut-off value of 0.49 ng/mL (sensibility = 77.6, specificity = 80.7). Conclusion The level of eTnI was significantly higher in patients with septic shock, cTnI was significantly correlated to left ventricular diastolic dysfunction in patients with septic shock, cTnI ≥ 0.49 ng/mL could be an available predictor for left ventrieular diastolic dysfunction in patients with septic shock.
作者 夏嘉鼎 苏震 王娜 秦诗阳 赵凯峰 XIA Jiad-ing, SU Zhen, WANG Na, QIN Shiyang, ZHAO Kaifeng. (Department of Intensive Care Unit, Affiliated Hospital of Chengde Medical College, Chengde 067000, China)
出处 《实用医学杂志》 北大核心 2017年第9期1449-1452,共4页 The Journal of Practical Medicine
基金 河北省科技支撑计划项目(编号:152777205)
关键词 脓毒性休克 左心室舒张功能 肌钙蛋白Ⅰ Septic shock Left ventricular diastolic function Troponin-I
作者简介 通信作者:赵凯峰E-mail:zhaokf5580@163.com
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  • 1Esper AM, Martin GS. Extending international sepsis epidemiology : the impact of organ dysfunction[ J]. Crit Care, 2009,13 ( 1 ) : 120. 被引量:1
  • 2Rossi MA, Celes MR, Prado CM, et al. , Myocardial structural changes in long- term human severe sepsis/septic shock may be responsible for cardiac dysfunction[J]. Shock, 2007,27( 1 ) :10 - 18. 被引量:1
  • 3van Bockel EA, Tulleken JE, Muller Kobold AC, et al. Cardiac troponin I release and cytokine response during experimental human endotoxaemia [ J ]. Intensive Care Med, 2003,29 (9) : 1598 - 1600. 被引量:1
  • 4Nduka OO, Parrillo JE. The pathophysiology of septic shock[ J]. Crit Care Clin, 2009,25(4) :677 -702. 被引量:1
  • 5Yin HY, Wei JR, Zhang R, et al. Changes in expressions of the myocardial Toll - like receptor 4, tumor necrosis factor - alpha and interleukin -6 mRNA in rat with sepsis [ J ]. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, 2009,21(8) :488 -491. 被引量:1
  • 6Kurt AN, Aygun AD, Godekmerdan A, et al. Serum IL - 1beta, IL - 6, IL - 8, and TNF - alpha levels in early diagnosis and management of neonatal sepsis[J]. Mediators Inflamm, 2007,2007:31397. 被引量:1
  • 7Prabhu SD. Cytokine - induced modulation of cardiac function[ J]. Circ Res, 2004,95 (12) : 1140 - 1153. 被引量:1
  • 8Kaczorowski DJ, Nakao A, McCurry KR, et al. Toll - like receptors and myocardial ischemia/reperfusion, inflammation, and injury [ J ]. Curr Cardiol Rev, 2009,5 (3) : 196 - 202. 被引量:1
  • 9Tsujimoto H, Ono S, Efron PA, et al. Role of Toll - like receptors in the development of sepsls[J]. Shock, 2008,29(3) :315 -321. 被引量:1
  • 10Crouser ED. Mitoehondrial dysfunction in septic shock and multiple organ dysfunction syndrome [ J]. Mitochondrion, 2004,4 ( 5 - 6 ) : 729 -741. 被引量:1

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