Objective:To study the levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with sepsis and myocardial. Methods: A total of 36 patients with sepsis were divided into myocardial injury group(n = 22) and non-myocardial injury group(n = 14). Twenty non-sepsis patients were also enrolled as a control group. The levels of NT-proBNP,creatine kinase-MB fraction (CK-MB) and Cardiac troponin T(cTnT)were detected in all patients of the 3 groups. Results: The levels of NT-proBNP,CK-MB and cTnT in myocardial injury group were significantly higher than those in non-myocardial injury group and control group (P<0.05). Receive operating characteristic (ROC) analysis was carried out,the area under the ROC curve (AUC) of ROC curve for the diagnosis of myocardial injury by NT-proBNP in sepsis was 0. 987. Conclusions; NT-proBNP can be used to diagnose myocardial injury at an early stage in patients with sepsis.%目的:探讨脓毒血症合并心肌损伤患者血浆N末端前体脑钠肽(N-terminal pro B-type natriuretic peptide,NT-proBNP)水平变化及其意义.方法:脓毒血症患者36例,根据心肌损伤诊断标准分为心肌损伤组(n=22)和非心肌损伤组(n=14),并选取20例同期非脓毒症住院患者作为对照组.比较各组的血肌酸激酶(reatine kinase-MB fraction,CK-MB)、心肌肌钙蛋白T(cardiac troponin T,cTnT)以及血浆NT-proBNP.结果:脓毒症合并心肌损伤组的血浆NT-proBNP为(872.12±235.47) pg/mL、CK-MB为(13.79±8.23) μg/mL和cTnT为(0.92±1.69)μg/mL；与另外2组相比差异均有统计学意义(P＜0.05).脓毒血症患者NT-proBNP、CK-MB和cTnT水平与对照组相比,差异均有统计学意义(P＜0.05).脓毒血症患者血浆的NT-proBNP水平与cTnT水平呈显著正相关(r=0.74,P=0.0001).采用受试者工作特征曲线(receive operating characteristic curve,ROC)曲线对脓毒血症患者的血浆NT-proBNP水平进行分析,ROC曲线下面积(area under curve,AUC)为0.987.结论:常规检测血浆NT-proBNP联合CK-MB和cTnT,能早期诊断脓毒症合并心肌损伤并指导治疗,防止心力衰竭的发生.
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