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目的:重症监护室脓毒症患儿心肌损伤临床指标与预后观察。方法:选取脓毒症患儿320例作为研究对象,用APACHEII(急性生理和慢性健康状况II)对患儿行动态评估,同时应用酶学法对患儿CK-MB予以检测,并用酶标免疫法对患儿cTnI予以测量。按照心肌cTnI与CK-MB检测结果酶学升高组(n=144)与酶学正常组(n=176),分析心肌损伤率与病死率。结果:心肌酶学异常率为45.0%;多器官衰竭病死率为12.5%,2.3%为正常组,25.0%为升高组,对比差异明显(P<0.05);入院时与入院7d酶学升高组APACHEII评分、CK-MB、cTnI以及ICU病死率均明显高于正常组,对比差异明显(P<0.05)。结论:cTnI与CK-MB升高提示重症监护室脓毒症患儿出现心肌损伤,同时该指标还可对患儿预后进行评价。
Objective: To observe the clinical indexes and prognosis of myocardial injury in children with sepsis in intensive care unit. Methods: Three hundred and seventy children with sepsis were selected as the study subjects. The dynamic assessment of children with APACHEII (Acute Physiology and Chronic Health Status II) was performed. At the same time, the CK-MB in children was detected by enzymology method. Act on children with cTnI be measured. According to myocardial enzymatic cTnI and CK-MB detection results of enzymatic elevated group (n = 144) and normal group (n = 176), analysis of myocardial injury and mortality. Results: The abnormal rate of myocardial enzymology was 45.0%. The mortality of multiple organ failure was 12.5%, 2.3% was normal group, 25.0% was elevated group, the difference was significant (P <0.05) The APACHEII score, CK-MB, cTnI and ICU mortality in high group were significantly higher than those in normal group (P <0.05). CONCLUSION: The elevated cTnI and CK-MB are indicative of myocardial injury in children with intensive care unit sepsis. In addition, this index can be used to evaluate the prognosis of children.