摘要
目的分析床边心脏超声联合心脏标志物在老年脓毒症心功能障碍中的诊治价值。方法选择本院重症医学科治疗老年脓毒症患者64例分为脓毒症心功能障碍组(32例)与脓毒症心功能正常组(32例),同期选择入院健康体检者32例为对照组。比较三组的二尖瓣环心肌运动速度[舒张早期血流速度(E)、舒张晚期血流速度(A)],左心室舒张/收缩末期容积(EDV/ESV)、左室射血分数(LVEF)、每搏输出量(SV)、每分输出量(CO)、E/A值以及α-羟丁酸脱氢酶(α-HBDH)、肌酸激酶同工酶(CK-MB)、N末端B型钠尿肽前体(NT-proBNP)、肌钙蛋白I(cTnI)、人心型脂肪酸结合蛋白(HFABP)水平,并绘制受试者工作特征(ROC)以及曲线下面积(AUC)。结果脓毒症心功能障碍组、脓毒症心功能正常组、对照组患者的H-FABP、NT-proBNP、α-HBDH、cTnI、CK-MB、EDV、ESV、SV、CO、LVEF、E/A水平比较,具有统计学意义(P<0.01)。经Logistics回归分析,EDV、SV、LVEF是脓毒症心功能障碍的保护因素,而CO、H-FABP、NT-proBNP是危险因素。心脏超声指标联合心脏标志物与单一指标的AUC比较,具有统计学意义(P<0.05),各指标间的的灵敏度、特异度比较,具有统计学意义(P<0.05)。结论心脏超声指标与心脏标志物二者联合诊断脓毒症患者合并心功能障碍具有较高的诊断价值。
Objective To analyze the value of bedside cardiac ultrasound combined with cardiac markers in the diagnosis and management of cardiac dysfunction in elderly sepsis.Methods Sixty-four cases of elderly sepsis patients treated in the Department of Intensive Care Medicine of our hospital were selected to be divided into sepsis cardiac dysfunction group(32 cases)and sepsis cardiac function normal group(32 cases),and 32 cases of those who were admitted to the hospital for health checkups were selected to be the control group in the same period.The mitral annulus myocardial velocities[early diastolic flow velocity(E),late diastolic flow velocity(A)],left ventricular end-diastolic/end-systolic volumes(EDV/ESV),left ventricular ejection fraction(LVEF),output per beat(SV),output per minute(CO),and E/A values,as well as the values of alpha hydroxybutyric acid dehydrogenase(α-HBDH),creatine kinase isoenzyme(CK-),N-terminal B-type kinase(N-terminal B)and N-terminal B-type kinase(N-terminal B),and the values of the N-terminal B-type kinase(N-terminal B),were compared.MB,N-terminal B-type natriuretic peptide precursor(NT-proBNP),troponin I(c TnI),and human heart-type fatty acid-binding protein(H-FABP)levels,and plotted the working characteristics of the subjects(ROC)as well as the area under the curve(AUC).Results The levels of H-FABP,NT-proBNP,α-HBDH,c TnI,CK-MB,EDV,ESV,SV,CO,LVEF,and E/A were compared among the patients in the septic cardiac dysfunction group,the septic cardiac function normal group,and the control group,which were statistically significant(P<0.01).After Logistics regression analysis,EDV,SV,and LVEF were protective factors for septic cardiac dysfunction,while CO,H-FABP,and NT-proBNP were risk factors.Comparison of the AUC of cardiac ultrasound indexes combined with cardiac markers and single indexes was statistically significant(P<0.05),and comparison of the sensitivity and specificity among the indexes was statistically significant(P<0.05).Conclusion The combination of both cardiac ultrasound indexes and cardiac markers has a high diagnostic value in the diagnosis of combined cardiac dysfunction in patients with sepsis.
作者
苑晓姣
解古月
吴新民
Yuan Xiaojiao;Xie Guyue;Wu Xinming(Department of Critical Care Medicine,Xinjiang Production and Construction Corps Hospital,Urumqi 830002;Department of Cardiovascular Medicine,Xinjiang Production and Construction Corps Hospital,Urumqi 830002;Plastic Surgery and Cosmetology Department of the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000)
出处
《新疆医学》
2023年第9期1098-1101,1121,共5页
Xinjiang Medical Journal
关键词
床边心脏超声
心脏标志物
脓毒症
心功能障碍
临床价值
Bedside cardiac ultrasound
Cardiac markers
Sepsis
Cardiac dysfunction
Clinical value
