摘要
目的观察感染性休克患者的肌钙蛋白变化,并分析其与患者预后的关系。方法随机观察了我院急诊科28例感染性休克的患者,所有患者均进入急诊抢救室治疗。于入院后6 h及24 h测定肌钙蛋白。记录患者的年龄、性别、心电图变化、预后及APACHEⅡ评分等。评估全部患者的肌钙蛋白升高率。分析肌钙蛋白与肌酸激酶及其同工酶的相关性。将患者分为肌钙蛋白升高组与肌钙蛋白正常组,比较两组患者APACHEⅡ评分、死亡率、最大血管活性药物需要量。结果全部患者中有16例患者肌钙蛋白升高,升高率为57%。肌钙蛋白与肌酸激酶同工酶相关。肌钙蛋白水平与APACHEⅡ评分、最大血管活性药物用量无相关性。升高组死亡率较正常组高,两组间APACHEⅡ评分无差异(P=0.34),升高组最大血管活性药物用量指数更大(P=0.03)。结论肌钙蛋白可在感染性休克患者中升高,与肌酸激酶同工酶相关。肌钙蛋白升高患者预后差,对血管活性药物的需求更大。肌钙蛋白测定可作为感染性休克预后监测的一项可靠指标。
Objective To investigate troponin Ⅰ changes in septic shock patients, and analyze its progno6is. Methods 28 septic shock patients who had been admitted into the resaseitation room were studied. Troponin Ⅰ and two other eardiae markers were measured 6 hours and 24 hours after admission. The elevated rate was ealeulated. The eorrelation between troponin Ⅰ and CK, CK - MB were evaluated. All the patients were allocated into two groups aeeording to their troponin Ⅰ level, the elevated group and the normal group. The APACHE Ⅱ score, age, CK level, CK- MB level, mortality and eateeholamine dose between the groups were eompared. Results Troponin Ⅰ was elevated in 16 of all the patients, elevation rate was 57%. Troponin Ⅰ and CK- MB were signitieanfly eorrelative （ r = 0.886, P = 0.000）. Troponin Ⅰ did not eorrelate with APACHE Ⅱ score or the dose of administered eateeholamine. The mortality was higher in elevated group than in the normal group, there was no signifieant differenee in APACHE Ⅱ score and age between the two groups, the eateeholamine dose of the elevated group was higher （ P = 0.03）. Conclusions Troponin Ⅰ can inerease in the septie shock patients, and eorrelates with CK- MB. The measurement of troponin Ⅰ is a useful marker for the prognostie surveillanee of septie shock. Patients with higher troponin Ⅰ need more eateeholamine.
出处
《中国急救医学》
CAS
CSCD
北大核心
2005年第9期633-635,共3页
Chinese Journal of Critical Care Medicine
