The Study Of The Cardiac Dysfunction And The Prognosis In Septic Myocardial Injury

Background: Sepsis is the systemic inflammatory response syndrome caused by infection,is the important factors of shock and MODS.The heart injury is one of serious complications in sepsis,the incidence can up to 40%,and can lead to poor prognosis,increase the risk of death rate.It thinks that sepsis cardiac dysfunction is especially myocardial systolic function obstacle.but recently,with the development of the hemodynamic monitoring and cardiac ultrasound technology,the researchers found that sepsis myocardial injury can be characterized by different types of cardiac dysfunction,such as left ventricular diastolic dysfunction,left ventricular systolic dysfunction and right ventricular dysfunction,and different types of cardiac dysfunction can exist with each other.UCG is a gold standard in evaluating sepsis myocardial suppression,it can reflect the systolic and diastolic function of the heart,that the other method can't replace.Objective: To confirm the cardiac dysfunction and assess the prognosis in sepsis myocardial injury through the ultrasonic cardiogram.Methods: This is a prospective study that collecting the septic patients from emergency department and department of infection disease at friendship hospital,capital medical university from 1 December 2015 to 31 December 2016.Test the cTnT,divided the septic patients into myocardial injury and non-myocardial injury group according to the cTnT,and divided the patients in myocardial injury group into 28 days survival group and death group according to the prognosis.To complete the echocardiographic examination.Analysis data by SPSS20.0 software.Results: Of the 96 sepsis patients,for 28 cases of myocardial injury,for 68 cases of non-myocardial injury,in the two groups,there was no statistically significant difference in age?gender? EDD? ESD(P>0.05),there were statistical difference in EF?E/A?E'/A' of interventricular septum?E'/A' of Left ventricular wall(P<0.05).In the 28 days survival group and death group,significant difference was found among EF?E'/A' of interventricular septum?E'/A' of Left ventricular wall(P<0.05).Risk factors of death was included EF?E'/A' of interventricular septum?E'/A' of Left ventricular wall through Logistic regression analysis.Using ROC curves,area under the curve of E'/A' of interventricular septum is 0.758,area under the curve of Left ventricular wall is 0.723,but there was no statistically significant difference(P>0.05).Significant difference was found in EF(P=0.025),the area under the curve is 0.795,the critical point of the higher sensitivity and specificity was 0.45,the sensitivity of 95.5%,the specificity of 92.6%.Conclusion: Exist the systolic and diastolic dysfunction in sepsis myocardial injury,E'/A' of interventricular septum and E'/A' of Left ventricular wall in evaluating ventricular diastolic function is more valuable than the EDD,and the lower the EF,the greater the risk of death,the worse prognosis.