Sheyin Olusegun, Davies Oluwaseun, Duan Wenlan, Perez Xavier
Department of Medicine, Harlem Hospital Center, in affiliation with the College of Physicians and Surgeons of Columbia University, New York, USA.
Department of Medicine, Harlem Hospital Center, in affiliation with the College of Physicians and Surgeons of Columbia University, New York, USA.
Heart Lung. 2015 Jan-Feb;44(1):75-81. doi: 10.1016/j.hrtlng.2014.10.002. Epub 2014 Nov 18.
To confirm the association between troponin elevation in patients with sepsis and mortality.
Cardiac troponins are sensitive and specific biomarkers of myocardial injury; however their prognostic significance in patients with sepsis is still debated.
PubMed and Ovid MEDLINE were searched for original articles using MeSH terms 'Troponin' and 'Sepsis.' Studies reporting on mortality in patients with sepsis, severe sepsis or septic shock who had troponin measured were eligible for inclusion. Meta-analysis was conducted with Review Manager.
Seventeen studies, with total sample size of 1857 patients were included. Elevated troponin was found to be significantly associated with mortality (Risk ratio: 1.91; 95% CI: 1.65-2.22; p < 0.05).
Troponin elevation in patients with sepsis confers poorer prognosis and is a predictor of mortality. Further studies are needed to see if more aggressive treatment of this subset of patients, or utilizing new therapeutic approaches will improve mortality.
证实脓毒症患者肌钙蛋白升高与死亡率之间的关联。
心肌肌钙蛋白是心肌损伤敏感且特异的生物标志物；然而，其在脓毒症患者中的预后意义仍存在争议。
使用医学主题词“肌钙蛋白”和“脓毒症”在PubMed和Ovid MEDLINE中检索原始文章。纳入报告了测量肌钙蛋白的脓毒症、严重脓毒症或脓毒性休克患者死亡率的研究。使用Review Manager进行荟萃分析。
纳入17项研究，总样本量为1857例患者。发现肌钙蛋白升高与死亡率显著相关（风险比：1.91；95%置信区间：1.65 - 2.22；p < 0.05）。
脓毒症患者肌钙蛋白升高预示预后较差，是死亡率的一个预测指标。需要进一步研究，以确定对这部分患者采取更积极的治疗或采用新的治疗方法是否会降低死亡率。
