脓毒症患者心功能障碍与QT间期离散度和肌钙蛋白的临床研究.docVIP

精品论文 参考文献 脓毒症患者心功能障碍与QT间期离散度和肌钙蛋白的临床研究 作者单位：贵阳市第一人民医院 550002 　　DOI：10.7504/nk2016010203 中图分类号：R587.1 文献标识码：A 　　摘要：目的:观察QT间期离散度和肌钙蛋白在脓毒症患者心功能障碍中的应用。方法：选取2012年01月～2014年11月急诊重症监护室和急诊科病房确诊脓毒症住院患者，根据疾病严重程度将患者分为脓毒症组（n=30）、严重脓毒症组（n=30）和脓毒性休克组（n=30）。采用化学发光法测定血清肌钙蛋白，采用ECG机及彩色超声超声超声机及彩色超声仪测定QT间期离散度。结果：严重脓毒症组和脓毒性休克组患者QT间期离散度QTd与Qticd及血清肌钙蛋白水平差异无统计学意义（Pgt;0.05）；脓毒症组QT间期离散度QTd与Qticd及血清肌钙蛋白水平，显著低于严重脓毒症组和脓毒休克组（Plt;0.05）。结论：脓毒症患者长期血液透析容易引起左室肥厚，QT间期离散度能预测血透患者左室肥大、心律失常指标；肌钙蛋白能预测脓毒症患者心脏损伤程度。 　　关键词：QT间期离散度；肌钙蛋白；脓毒症；心功能障碍 　　Clinical study of cardiac dysfunction in patients with sepsis and QT interval dispersion and troponin 　　Abstract Objective: To observe the QT interval dispersion and troponin used in cardiac dysfunction in patients with sepsis. Methods: January 2014 - April 2016 90 cases of sepsis patients to hospital for treatment, according to the severity of the disease patients were divided into sepsis group (n = 30), severe sepsis group (n = 30) and septic shock group (n = 30). Serum troponin chemiluminescence method using ECG machine and color Doppler ultrasound and color Doppler ultrasound machine measured QT interval dispersion. Results: The group with severe sepsis and septic QT interval dispersion QTd and Qticd and serum troponin levels in patients with shock group was no significant difference (Pgt; 0.05); sepsis group QT interval dispersion QTd and Qticd and serum troponin levels, significantly lower than the group with severe sepsis and septic shock group (P lt;0.05). Conclusion: The long-term hemodialysis patients with sepsis easily lead to left ventricular hypertrophy, QT interval dispersion in patients with left ventricular hypertrophy in hemodialysis can predict arrhythmia indicators; troponin can predict the extent of heart damage in patients with sepsis. 　　Key words: QT dispersion degree; troponin; sepsis; cardiac dysfunction 　　脓毒症（sepsis）属于感染诱发的全身性炎症反应，容易引起感染性休克、多器官功能障碍，严重者将威胁患者生命[1]。心脏功能障碍是脓毒症患者中最严重的并发症，也是院内死亡的主要原因[2]。文献报道显示[3]：心肌损伤在脓毒症早期存在，且患者心肌损害越早，病情越