The Clinical Value Of Combined Detection Of PCT,NT-proBNP And CTn? In The Diagnosis Of Sepsis Cardiomyopathy

Background:Sepsis has become a major global public health problem and one of the major causes of death in severe patients.The myocardial insufficiency caused by Sepsis is known as Sepsis cardiomyopathy.Due to the lack of specific clinical manifestations and sensitive clinical monitoring indicators in the early stage of sepsis cardiomyopathy,the difficulty in early identification delays the best time for diagnosis and treatment,leading to a high fatality rate.Procalcitonin(PCT)has important clinical guiding value for the determination of suspicious infection,the evaluation of antibiotic treatment effect and the evaluation of infection degree.At present,a large number of animal and clinical studies have shown that PCT can be used as a marker for the diagnosis of sepsis,and the concentration of PCT in plasma is closely related to the severity and prognosis of sepsis.Cardiac troponin I(cTn?)is a highly sensitive and specific biochemical marker for the diagnosis of myocardial injury.Clinical workers usually refer to the level of cTn? to judge the myocardial injury,and the level of cTn? is positively correlated with the degree of myocardial cell injury.Amino terminal brain natriuretic peptide precursor(NP-probNP)is no biological activity of the amino acid fragment,the higher the concentration in the plasma,the more serious the degree of cardiac dysfunction.It may be more sensitive as a marker of early cardiac dysfunction.The changes of ventricular volume and the increase of ventricular wall tension are the key factors affecting the secretion of NT-probNP.To date,there is no clinical "gold standard" for the diagnosis of sepsis cardiomyopathy.Relevant studies at home and abroad have shown that no single marker has sufficient sensitivity and specificity in routine clinical practice.Therefore,combined detection of multiple indicators for the early diagnosis of sepsis cardiomyopathy is a trend of current research.This study hopes to explore the clinical value and clinical significance of combined detection of PCT,NT-probNP and cTn? in the early diagnosis of sepsis cardiomyopathy.Objective: To study the clinical value of plasma PCT,NT-probNP and cTn? in the early diagnosis of sepsis cardiomyopathy.Method: Selection in January 2017-December 2018,our hospital intensive medicine treated 116 cases of patients with sepsis,according to the patients in the diagnosis of sepsis in monitoring the heart colour to exceed EF value as a result,divided into sepsis of cardiomyopathy group(EF value 50% or higher)and sepsis cardiomyopathy group(EF value < 50%),all the diagnosis of sepsis patients immediately extraction of peripheral venous blood,respectively,the determination of serum PCT,NT-proBNP and cTn? levels,and comparative analysis.Results: Age,gender,height,weight,heart rate,mean arterial pressure(MAP),body mass index(BMI),central venous pressure(CVP)and other indicators were not significantly different between the sepsis cardiomyopathy group and the sepsis non-cardiomyopathy group(P > 0.05),indicating comparability.1.Compared with the sepsis non cardiomyopathy group,the PCT,NT-proBNP and cTn? of the sepsis cardiomyopathy group were significantly higher(P<0.05);2.The levels of PCT,NT-proBNP and cTn? were negatively correlated with EF;3.PCT,NT-proBNP and cTn? were independent risk factors,the difference was statistically significant(P<0.05);4,Separate detection of PCT,NT-proBNP,cTn?,its sensitivity,specificity can not guarantee at the same time,when the three combined detection,can improve the sensitivity and specificity of diagnosis.Conclusion: PCT,NT-proBNP and cTn? were independent risk factors.Combined with clinical conditions,combined detection of PCT,NT-proBNP and cTn? was more advantageous than single index detection,which could guide clinicians to make accurate early diagnosis of sepsis cardiomyopathy and had important value in the treatment of sepsis.