本文選題：膿毒性休克 + 左心室舒張功能　； 參考：《實(shí)用醫(yī)學(xué)雜志》2017年09期

【摘要】：目的:探討膿毒性休克致左心室舒張功能障礙患者肌鈣蛋白I(c Tn I)的變化及臨床價(jià)值。方法:回顧性分析重癥醫(yī)學(xué)科(ICU)收治的膿毒性休克致左心室舒張功能障礙患者38例(Sa組),膿毒性休克心功能正常患者20例(Sn組),未診斷膿毒性休克但發(fā)生左心室舒張功能障礙患者20例作為對(duì)照組(Ca組),于入ICU 72 h內(nèi)應(yīng)用超聲心動(dòng)圖通過(guò)測(cè)定二尖瓣舒張?jiān)缙诜辶魉倥c二尖瓣環(huán)舒張?jiān)缙谶\(yùn)動(dòng)速度比值(E/e′)評(píng)估心臟舒張功能,同時(shí)檢測(cè)c Tn I。比較各組c Tn I水平差異及其與E/e′相關(guān)性。繪制受試者工作者特征曲線(ROC),評(píng)估c Tn I預(yù)測(cè)膿毒性休克患者致左心室舒張功能障礙發(fā)生的價(jià)值。結(jié)果:Sa組、Sn組的c Tn I水平均較Ca組明顯增高(P0.05);Sa組c Tn I水平、E/e′明顯高于Sn組(P0.05)。c Tn I與E/e′呈正相關(guān)(r=0.367,P=0.004)。ROC顯示c Tn I為0.49 ng/m L時(shí)預(yù)測(cè)膿毒性休克致左心室舒張功能障礙發(fā)生的曲線下面積為0.834,敏感度為77.6%,特異度為80.7%。結(jié)論:膿毒性休克患者c Tn I水平明顯升高,c Tn I升高與膿毒性休克致左心室舒張功能障礙密切相關(guān),c Tn I≥0.49 ng/m L可有效預(yù)測(cè)膿毒性休克致左心舒張功能障礙的發(fā)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，

本文編號(hào)：2037700