Zhen Junhai, Li Li, Yan Jing
Department of Second Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou 310053, Zhejiang, China (Zhen JH); Department of Intensive Care Unit, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China (Li L, Yan J). Corresponding author: Yan Jing, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Jul;30(7):699-702. doi: 10.3760/cma.j.issn.2095-4352.2018.07.017.
Sepsis is a common disease in critical patients, which may lead to myocardial damage, thereby aggravating the severity of the patients' condition, and causing adverse prognosis. How to detect sepsis with myocardial injury as early as possible, and use corresponding treatment measures on time are essential. Cardiac troponin I (cTnI), brain natriuretic peptide (BNP), myoglobin (Mb), MB isoenzyme of creatine kinase (CK-MB) and other traditional cardiac markers are easily affected by the complications of other critical diseases, thus the diagnostic value of those markers for myocardial injury of sepsis is reduced. In recent years, there have been some studies on heart-type fatty acid binding protein (H-FABP), microRNA (miRNA), soluble triggering receptor expressed on myeloid cell-1 (sTREM-1), high mobility group protein B1 (HMGB1), neutrophil gelatinase-associated lipocalin (NGAL), histone and other new biomarkers of myocardial injury in septic patients. This article reviewed the value of these unconventional cardiac markers in the diagnosis of sepsis-induced myocardial injury, with the hope to provide some help for clinic.
脓毒症是危重症患者中的常见疾病，可导致心肌损伤，进而加重患者病情严重程度并造成不良预后。如何尽早检测出合并心肌损伤的脓毒症并及时采取相应治疗措施至关重要。心肌肌钙蛋白I（cTnI）、脑钠肽（BNP）、肌红蛋白（Mb）、肌酸激酶同工酶MB（CK-MB）等传统心脏标志物易受其他危重症并发症影响，因此这些标志物对脓毒症心肌损伤的诊断价值降低。近年来，关于心型脂肪酸结合蛋白（H-FABP）、微小RNA（miRNA）、髓系细胞触发受体-1（sTREM-1）、高迁移率族蛋白B1（HMGB1）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、组蛋白等脓毒症患者心肌损伤新生物标志物有一些研究。本文综述了这些非传统心脏标志物在脓毒症所致心肌损伤诊断中的价值，以期为临床提供一些帮助。
