| Objective:To investigate the predictive value of sST2 combined with NT-pro BNP on myocardial dysfunction in patients with sepsis and the significance of prognosis evaluation in patients with sepsis.Methods:A total of 60 patients with sepsis diagnosed and treated in the ICU of our hospital from January2021 to December 2021 were collected.1.Patients were divided into sepsis cardiomyopathy group(SIMD group,LVEF< 50%)and sepsis non-cardiomyopathy group(non-SIMD group,LVEF≥50%).The levels of sST2 and NT-pro BNP,myocardial injury markers and infection indexes were compared between the two groups on the first,third and fifth days after admission,and the correlation between sST2 and LVEF(%)and the above indexes was analyzed.ROC curve was used to analyze the predictive value of sST2,NT-pro BNP,c Tn I,PCT and CRP for myocardial injury in patients with sepsis at each time point(the 1st,3rd and 5th day of admission),and the predictive value of sST2 combined with NT-prob NP for myocardial injury in patients with sepsis at each time point was also analyzed.2.SIMD patients were divided into AKI group and non-AKI group according to the occurrence of Acute kidney injury.sST2 and NT-pro BNP of patients in the two groups at 1,3 and 5 days were collected to further evaluate the changes of sST2 level in septic cardiomyopathy complicated with kidney injury.3.Based on SOFA scores within 24 hours of admission,patients were divided into SOFA score >5 group and SOFA score ≤5 group.sST2,NT-pro BNP,myocardial injury markers and infection indexes were collected on the first,third and fifth days after admission for comparison between groups.ROC curve was used to analyze the predictive value of sST2 and NT-pro BNP for the severity of sepsis patients at each time point(the1st,3rd and 5th day of admission).4.According to the 28-day survival,patients were divided into death group and survival group,sST2,NT-pro BNP,myocardial injury markers,infection indicators and APACHEII score were collected on the 1st,3rd and 5th day of admission for comparison between groups,and the correlation between sST2 and APACHEII score was analyzed.ROC curve was used to analyze the predictive value of sST2,NT-pro BNP and sST2 combined with NT-pro BNP for the prognosis of patients with sepsis at each time point(the 1st,3rd and 5th day of admission).Results:1.The sST2,c Tn I,PCT and CRP levels on the 1st,3rd and 5th days,NT-pro BNP levels on 1st,5th days and WBC level on 5th days of SIMD group were significantly higher than those of non-SIMD group,and the sST2 level on the 1st,3rd and 5th days of admission was positively correlated with c Tn I,PCT and CRP levels at each time point.They were negatively correlated with LVEF and PLT levels on the 3rd day of admission.The sST2 level of patients with septic myocardial injury in AKI group was higher than that in non-AKI group on the third day of admission.2.ROC curve analysis data for predicting sepsis cardiomyopathy showed that the maximum area under curve of sST2 on the first day of admission was 0.971,the sensitivity and specificity were 0.955 and 0.842,and the cut-off value was 177.515ng/m L.On the first day of admission,the area under the curve of NT-pro BNP was 0.745,the sensitivity and specificity were 0.864 and 0.658,and the cut-off value was 4284.37pg/m L.Compared with NT-prob NP,sST2 had higher sensitivity and specificity in predicting SIMD on the first day of admission.In ROC curve analysis of predicting SIMD by sST2 combined with NT-pro BNP,the area under the curve of sST2 combined with NT-pro BNP on the first day of admission was the largest,which was 0.971,and the sensitivity and specificity were 0.955 and 0.842.3.The levels of sST2,PCT,MYO levels on the 1st,3rd and 5th days and NT-pro BNP,c Tn I,CK-MB levels on the 1st day after admission of SOFA score >5 group were all higher than those in SOFA score ≤5 group.And the levels of PLT on the 1st,3rd and 5th days were lower than that in SOFA score ≤5 group.ROC curve analysis data for predicting the severity of sepsis patients showed that sST2 had the largest area under the curve(0.753)on the fifth day of admission,with a sensitivity and specificity of 0.743 and 0.640 and the cut-off value was 61.215ng/m L.4.sST2 levels on 1st 、3rd and 5th days and NT-pro BNP levels on 3rd and 5th days and APACHE II score at discharge,PCT,CRP and CK-MB levels on the 5th day,MYO,IL-6 and NEUT% levels on the 3rd day and PLT level on the 1st day in the death group were significantly higher than those in the survival group.Moreover,sST2 level on the third day of admission was positively correlated with APACHE II score on admission and exit.ROC curve analysis data for predicting the prognosis of sepsis patients showed that sST2 had the largest area under the curve(0.786)on the fifth day of admission,with a sensitivity and specificity of 0.800 and 0.800,respectively,and the cut-off value was 98.54ng/m L.Conclusion:1.Compared with NT-pro BNP and c Tn I,sST2 can better evaluate the occurrence and severity of septic cardiomyopathy.2.sST2 can be used as an indicator to predict the severity and poor prognosis of sepsis. |
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