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[目的]观察严重脓毒症患者血肌钙蛋白Ⅰ(cTnⅠ)水平和对预后的判断价值。[方法]以2005年1月～2010年2月121例成年严重脓毒症患者为研究对象,采用回顾性病例对照研究,采集患者的一般资料、入ICU48h内cTnⅠ水平和机械通气例数、机械通气时间、ICU住院时间和28d病死率。[结果]39例患者cTnⅠ水平升高,cTnⅠ升高组和正常组年龄、性别、机械通气例数比较无统计学差异(P﹥0.05)。和cTnⅠ正常组比较,cTnⅠ升高组APACHEⅡ评分、应用升压药物例数、机械通气时间、ICU住院时间和28d病死率明显高于正常组(P﹤0.05)。多因素Logistic分析显示cTnⅠ水平升高是严重脓毒症患者28d病死率的危险因素。[结论]cTnⅠ水平升高可反映严重脓毒症患者心肌受损的程度,可作为预后监测的重要指标。
[Objective] To observe the level of cTnⅠ in patients with severe sepsis and its prognostic value. [Methods] A total of 121 adult patients with severe sepsis from January 2005 to February 2010 were enrolled in this study. A retrospective case-control study was conducted. The general data of patients, the level of cTnⅠ and the number of mechanical ventilation within 48 hours after ICU were collected. Ventilation time, ICU length of stay and 28-day mortality. [Results] The levels of cTnⅠ were increased in 39 patients. There was no significant difference in the age, sex and the number of mechanical ventilation between cTn Ⅰ elevated group and normal group (P> 0.05). Compared with the normal cTnI group, the APACHEⅡscore of elevated cTnI group was significantly higher than that of the normal group (P <0.05). The number of vasopressors, mechanical ventilation time, ICU hospital stay and 28d mortality were significantly higher than those in normal group. Multivariate Logistic analysis showed that elevated cTnI was a risk factor for 28-day mortality in patients with severe sepsis. [Conclusion] Elevated cTnI level can reflect the degree of myocardial damage in patients with severe sepsis and can be used as an important indicator of prognosis monitoring.