The Clinical Value Of Cardiac Troponin â…  Level Quota Examination In Critically Ill Patients

Object To explore myocardial necrosis could occur in critical care patients with acute non -cardiac illness while followed MODS and search for the relation between myocardial injury and prognosi by testing the levels of cardiac troponin I.Method According to clinic dignostic criteria,50 critical care patients with acute non -cardiac illness while followed MODS were enrolled in this study as test group.50 patients with MODS were divided into survival group and death group, shock group and non-shock group,severe arrhythmia group and general arrhythmia group.There were 33 patients in survival group,17 patients in death group;12 patients in shock group,38 patients in non-shock group;11 patients in severe arrhythmia group,39 patients in general arrhythmia group.they were tested of the level of cardiac troponin I,and were recorded electrocardiogrqphy in illness phasa.The results were contrasted with 50 patients in AMI group (positive control group)and 50 nomal people in nomal group(negative control group)and were contrasted with other groups respectively and analyzed by statistical methods.The measurement datum are indicated with((?)+s).Among the three groups,they were analyzed by One-Way ANOVA;Between the two groups they were analyzed by Independent-Samples T test.The difference was statistically significant at P＜0.05.Result Among the three groups,they were similar in terms of age and sex,The peak levels of cTnI in tested group on admission were(5.78±2.30)μg/L,In the positive contrast group,they were(21.10±6.92)μg/L,in the negative contrast group,they were(0.05±0.02)μg/L,In death group,they were(7.00±1.90)μg/L,in survival group,they were(5.16±2.27)μg/L.In shock group, they were(7.53±2.07)μg/L,in non-shock group,they were(5.23±2.11)μg/L.In severe arrhythmia group,they were(7.25±2.19)μg/L,in general arrhythmia group,they were (5.37±2.19)μg/L.The levels of cTnI in MODS group were significantly higher than those in negative control group and significantly lower than those in positive control group respectively p＜0.001.The levels of them in death group were significantly higher than those in survival group respectively p＜0.01.The levels of them in shock group were significantly higher than those in non-shock group respectively p＜0.01.The levels of them in severe arrhythmia group were significantly higher than those in general arrhythmia group respectively p＜0.05.Dynamic changes of cardiac troponin:In death group,with approach to the date of death,the levels of cTnI is higher than those previously.In survival group,with the improvement of disease,the levels of cTnI are declined gradually and returned to a normal level finally. Conclusion Patients with MODS have myocardial injury in deferent degrees.The more significantly the peak levels of cTnI increased,the more severely the heart tissue was damaged.The quota examination of cTnI level has great value in diagnosing critically ill patients with myocardial injury.