急腹症致脓毒性心肌病的血清学预测指标研究

Study on Serological Predictors of Septic Cardiomyopathy Caused by Acute Abdomen

摘要: 目的：探讨H-FABP、CK-MB、cInI对于急腹症发生脓毒性心肌病的预测价值。方法：回顾性分析2018年月至2023年10月在陕西省人民医院在SICU和ICU的急腹症患者的临床资料。共纳入131例急腹症发生脓毒症患者，按是否发生脓毒性心肌病(sepsis-induced cardiomyopathy, SIC)分为心肌病组(n = 79)和无心肌病组(n = 52)。患者入院均行超声心动图检查，以及血常规、感染指标、心肌损伤标志物等多实验室指标测定，采用二元logistic回归分析筛选出急腹症发生SIC的独立危险因素。经受试者工作特征(ROC)曲线评估各指标的预测价值。结果：共纳入131例，急腹症致SIC的发病率为60.3%，病死率为41.77%，据二元logistic回归分析显示，H-FABP、CK-MB、cTnI是急腹症患者发生SIC的独立危险因素(P < 0.05)。ROC曲线分析显示，H-FABP、CK-MB、cTnI的曲线下面积分别是0.885、0.934、0.865。结论：H-FABP、CK-MB、cTnI是急腹症患者发生SIC的独立危险因素，三者中CK-MB对于SIC的预测价值最高。

Abstract: Objective: To explore the predictive value of H-FABP, CK-MB, cTnI for septic cardiomyopathy in acute abdomen. Methods: The clinical data of acute abdomen patients in SICU and ICU of Shaanxi Provincial People’s Hospital from 2018 to October 2023 were retrospectively analyzed. A total of 131 patients with sepsis were enrolled and divided into two groups based on the occurrence of sepsis-induced cardiomyopathy (sepsis-induced cardiomyopathy, SIC): the cardiomyopathy group (n = 79) and the non-cardiomyopathy group (n = 52). All patients underwent echocardiography, blood routine, infection indicators, myocardial injury markers and other laboratory indicators. Logistic regression analysis was used to screen the independent risk factors of SIC. Results: A total of 131 cases were included. The incidence of septic cardiomyopathy in acute abdomen was 60.3%, and the mortality was 41.77%. According to binary logistic regression analysis, H-FABP, CK-MB, cTnI were independent risk factors for SIC in patients with acute abdomen (P < 0.05). ROC curve analysis showed that the areas under the curve of H-FABP, CK-MB and cTnI were 0.885, 0.934 and 0.865, respectively. Conclusion: H-FABP, CK-MB and cTnI are independent risk factors for SIC in patients with acute abdomen, and CK-MB has the highest predictive value for SIC.