Smith Andria, John Molly, Trout Rachael, Davis Elaine, Moningi Shalini
Robert C. Byrd Health Sciences Center, WVU, Charleston, USA.
W V Med J. 2009 Jul-Aug;105(4):29-32.
Serum troponins are sensitive markers used to diagnose acute coronary syndrome in association with signs and symptoms of chest pain and EKG changes. Cardiac troponins are elevated in 85% of patients with sepsis in the absence of acute coronary syndrome. Small studies have shown that elevated troponin levels identify patients with sepsis who are at increased risk of mortality. The purpose of this study was to (1) identify the outcome of cardiac troponin positive sepsis patients in our hospital, (2) determine whether the traditional cardiac risk factors predispose septic patients for positive troponin and (3) evaluate the cardiac interventions done for troponin positive patients.
In our study, patients with elevated troponins had a higher mortality. Hypertension (HTN) and Coronary Artery Disease (CAD) increased the risk of mortality in troponin positive patients. Several interventions were performed including medications, echocardiogram, and cardiology consultation. Treatment medications did not improve mortality rates.
血清肌钙蛋白是用于结合胸痛体征和症状以及心电图变化来诊断急性冠脉综合征的敏感标志物。在没有急性冠脉综合征的情况下，85%的脓毒症患者心肌肌钙蛋白会升高。小型研究表明，肌钙蛋白水平升高可识别出脓毒症死亡风险增加的患者。本研究的目的是：（1）确定我院心肌肌钙蛋白阳性脓毒症患者的预后；（2）确定传统心脏危险因素是否使脓毒症患者肌钙蛋白呈阳性；（3）评估对肌钙蛋白阳性患者进行的心脏干预措施。
在我们的研究中，肌钙蛋白升高的患者死亡率更高。高血压（HTN）和冠状动脉疾病（CAD）增加了肌钙蛋白阳性患者的死亡风险。进行了多种干预措施，包括药物治疗、超声心动图检查和心内科会诊。治疗药物并未提高死亡率。
