摘要
目的探讨ICU脓毒血症患者合并心肌损伤的临床分析。方法纳入该院ICU于2017年1月—2019年12月期间收治的脓毒血症患者80例。以回顾性分析形式,对80例患者的基础数据和病症数据分析,对脓毒血症出现心肌损伤的危险因素予以评定。结果 80例患者中共38例(47.50%)出现心肌损伤。患者心肌损伤和血糖(≤11.1 mmol/L为58.33%,>11.1 mmol/L为15.00%)、 N末端脑钠肽前体(NT-proBNP)(≤300 pg/mL为33.33%,>300pg/mL为65.71%)、PCT (≤5.0 ng/mL为26.32%,>5.0 ng/mL为66.67%)、C-反应蛋白(≤100 mg/L为31.25%,>100mg/L为54.17%)、白细胞(≤15×109/L为27.59%,>15×109/L为58.82%)、急性生理与慢性健康评分(≤22分为34.00%,>22分为68.18%)、平均动脉压(<60 mmHg为68.75%,≥60 mmHg为33.33%)有关(χ~2=12.135,P=0.000;χ~2=8.278,P=0.004;χ~2=8.816,P=0.003;χ~2=4.074,P=0.044;χ~2=7.234,P=0.007;χ~2=9.744,P=0.002;χ~2=9.658,P=0.002)。重度脓毒血症患者中,NT-proBNP、PCT、CRP、MAP以及APACHEII分值和血糖是导致心肌损伤的独立危险要素。结论多因素会造成ICU脓毒血症患者出现心肌损伤,所以进行治疗时需要关注患者实验室指标的变化,有效提升患者预后质量。
Objective To explore the clinical analysis of ICU sepsis patients with myocardial injury.Methods Eighty patients with sepsis admitted to the hospital from January 2017 to December 2019 were included.In the form of retrospective analysis,the basic data and disease data of 80 patients were analyzed,and the risk factors of myocardial injury in sepsis were evaluated.Results A total of 38(47.50%)of the 80 patients had myocardial injury.Patients with myocardial injury and blood glucose(<11.1 mmol/L 58.33%,>11.1 mmol/L 15.00%),N-terminal brain natriuretic peptide precursor(NT-proBNP)(<300 pg/mL 33.33%,>300 pg/mL 65.71%),PCT(<5.0 ng/mL 26.32%,>5.0 ng/mL66.67%),C-reactive protein(<100 mg/L 37.50%,>100 mg/L 54.17%),namely white blood cells(≤15×109/L 27.59%,>15×109/L 58.82%),acute physiology and chronic health score(≤22 points 34.00%,>22 points 68.18%),average arterial pressure(<60 mmHg 68.75%,>60 mmHg 33.33%)related(χ~2=12.135,P=0.000;χ~2=8.278,P=0.004;χ~2=8.816,P=0.003;χ~2=4.074,P=0.044;χ~2=7.234,P=0.007;χ~2=9.744,P=0.002;χ~2=9.658,P=0.002).In patients with severe sepsis,NT-proBNP,PCT,CRP,MAP,and APACHEII scores and blood glucose are independent risk factors for myocardial damage.Conclusion Multiple factors can cause myocardial injury in patients with sepsis of ICU,so attention should be paid to the changes in laboratory indicators of patients during treatment to effectively improve the quality of patients’prognosis.
作者
陆斌
曹卫华
李冬申
胡明月
LU Bin;CAO Wei-hua;LI Dong-shen;HU Ming-yue(ICU,Haimen Traditional Chinese Medicine Hospital,Haimen,Jiangsu Province,226100 China)
出处
《系统医学》
2020年第13期34-36,102,共4页
Systems Medicine
