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

发布时间：2018-06-19 01:23

  本文选题：脓毒性休克 + 左心室舒张功能　； 参考：《实用医学杂志》2017年09期

【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(c Tn I)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ICU 72 h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c Tn I。比较各组c Tn I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c Tn I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c Tn I水平均较Ca组明显增高(P0.05);Sa组c Tn I水平、E/e′明显高于Sn组(P0.05)。c Tn I与E/e′呈正相关(r=0.367,P=0.004)。ROC显示c Tn I为0.49 ng/m L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c Tn I水平明显升高,c Tn I升高与脓毒性休克致左心室舒张功能障碍密切相关,c Tn I≥0.49 ng/m L可有效预测脓毒性休克致左心舒张功能障碍的发生。
[Abstract]:Objective: to investigate the changes and clinical value of cardiac troponin I c T n I in patients with left ventricular diastolic dysfunction caused by septic shock. Methods: 38 patients with left ventricular diastolic dysfunction caused by septic shock and 20 patients with normal cardiac function after septic shock were analyzed retrospectively. Septic shock was not diagnosed but left ventricular diastolic dysfunction occurred. Twenty patients with diastolic dysfunction were selected as control group. Echocardiography was used to evaluate the diastolic function by measuring the ratio of mitral early diastolic peak velocity to mitral annular early diastolic velocity and mitral annular early diastolic velocity during 72 hours in ICU. At the same time, c TN I was detected. To compare the difference of c TnI level and its correlation with E / E'in each group. To evaluate the value of c TN I in predicting left ventricular diastolic dysfunction in patients with septic shock. Results the level of c TnI in Sn group was significantly higher than that in Ca group. The level of c TnI in Sa group was significantly higher than that in Sn group. It was significantly higher than that in Sn group. There was a positive correlation between c TnI and E / E 'and the prediction of left ventricular diastolic work induced by septic shock was predicted when c TNI was 0.49 ng/m / L The area under the curve was 0.834, the sensitivity was 77.6 and the specificity was 80.7. Conclusion: the elevated level of c TnI in septic shock patients is closely related to left ventricular diastolic dysfunction induced by septic shock. CTnI 鈮，

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