Objective Once sepsis appears cardiac dysfunction,mortality is high,so early diagnosis has significant clinical significance,this study explored the role of tumor necrosis factor-α(TNF-α) and pro-B-type brain natriuretic peptide(Pro-BNP) in sepsis induced myocardial dysfunction.
Methods Fifty patients with Sepsis induced myocardial dysfunction were involved.After 24 h admission according to cardiac ultrasound examination for left ventricular ejection fraction(LVEF),the patients were divided into LVEF ≤ 40% group and LVEF>40% group.According to the prognosis was divided into survival group and death group.TNF-α,B-type pro-brain natriuretic peptide(Pro-BNP) and TNI were measured in the selected patients.APACHE Ⅱ score was recorded.Left ventricular end-diastolic diameter(LVSD) was measured by echocardiography.The levels of TNF-α,Pro-BNP and APACHE Ⅱ scores and the correlation between TNF-α,Pro-BNP and LVEF were analyzed.The ROC curve was used to evaluate the specificity and sensitivity of TNF-α and Pro-BNP in the diagnosis of cardiac dysfunction.
Results The levels of TNF-α,Pro-BNP and APACHEⅡ in LVEF>40% group were lower than those in LVEF ≤ 40% group.The difference was statistically significant.TNF-α,TNI in survival group was lower than that in death group.Pro-BNP,LVSD in the two groups was
P<0.01;LVEF (40.03±1.50) was significantly higher than that in the death group(38.76±2.86),but no statistically significant difference.There was correlation between TNF-α,Pro-BNP and APACHEⅡ score(
r=0.88,
P<0.05;
r=0.70,
P<0.05).TNF-α and Pro-BNP were negatively correlated with LVEF(
r=-0.76,
P<0.05;
r=-0.79,
P<0.05).The area under the ROC curve of TNF-α was 0.772 and the area under the ROC curve of Pro-BNP was 0.771.
Conclusion TNF-α and Pro-BNP were significantly increased in patients with Sepsis induced myocardial dysfunction.The increase of TNF-α and Pro-BNP correlated with poor prognosis.
DownLoad: