Objective The mortality in sepsis patients with myocardial injury is high, and the early diagnosis is of great significance. The aim of this paper is to discuss the application of Pro-BNP and cTnI in patients with sepsis induced myocardial injury.
Methods From February 2016 to August 2017, 40 patients with sepsis related myocardial injury in Department of Critical Care Medicine of Hangzhou First People's Hospital were recruited. According to left ventricular ejection fraction (LVEF) after admission, the patients were divided into LVEF>40% group (23 cases) and LVEF≤40% group (17 cases); Likewise, according to the prognosis, the patients were divided into survival group (24 cases) and death group (16 cases). The levels of Pro-BNP, cTnI and lactic acid were measured, APACHE Ⅱ score was recorded; LVEDD was measured by echocardiography, dp/dt max was monitored by PiCCO. The area under the ROC curve was used to analyze the prognostic value of Pro-BNP and cTnI in patients with sepsis related myocardial injury. The correlation among Pro-BNP, cTnI and LVEF were also analyzed.
Results The Pro-BNP, cTnI, lactic acid, LVEDD, APACHEⅡ scores in the LVEF>40% group were all less than those in the LVEF≤40% group, and the dp/dt max was greater than the LVEF≤40% group, the difference was statistically significant; The Pro-BNP, cTnI, lactic acid, and APACHEII scores of the survival group were lower than those of the death group. The dp/dt max of the survival group was greater than that of the death group, and the differences were statistically significant. For prediction of prognosis in patients with sepsis myocardial injury, the sensitivity of Pro-BNP was 0.82, specificity was 0.80, an area under the ROC curve of 0.88; the sensitivity of cTnI was 0.93, specificity was 0.88, and the area under the ROC curve was 0.96. There was a negative correlation between Pro-BNP, cTnI and LVEF (
r=-0.360,
P=0.023;
r=-0.315,
P=0.048).
Conclusion Both Pro-BNP and cTnI increases in the patients with sepsis related myocardial injury, the increase of pro-BNP and cTnI may correlate with poor prognosis.
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