罗友军　谭转欢　李新君　徐维利1.东莞三局医院检验科，广东东莞　52710；2.东莞三局医院儿科，广东东莞　52710；.鄂东医疗集团黄石市中医院检验科，湖北黄石　45100

血清cTnI、CK-MB、NT-proBNP联合检验在脓毒症患儿中的作用探讨

罗友军1谭转欢1李新君2徐维利3
1.东莞三局医院检验科，广东东莞523710；2.东莞三局医院儿科，广东东莞523710；3.鄂东医疗集团黄石市中医院检验科，湖北黄石435100

目的探讨血清cTnI、CK-MB、NT-proBNP联合检验在脓毒症患儿中的作用。 方法选择2015年5月～2016年1月间在我院就诊的60例脓毒症患儿的临床资料，按病情分为轻症脓毒症组（n=30）和重症脓毒症组（n=30），随机选择30例来我院进行健康体检的性别、年龄与脓毒症患儿匹配的健康儿童作为对照组，检测三组的CK-MB、cTnI，NT-proBNP水平，比较不同标志物单独检测及联合检测的灵敏度、特异性及阳性预测率。 结果重症脓毒症组CK-MB、cTnI、NT-proBNP水平高于轻症脓毒症组及对照组，差异有统计学意义（P＜0.05）；轻症脓毒症组CK-MB、cTnI、NT-proBNP水平高于对照组，差异有统计学意义（P＜0.05）。CK-MB、cTnI的灵敏度高于NT-proBNP，cTnI、NT-proBNP特异性高于CK-MB，差异有统计学意义（P＜0.05）；联合检测的灵敏度、特异性及阳性预测率与三项标志物单独检测比较更高，差异有统计学意义（P＜0.05）。结论 脓毒症患儿CK-MB、cTnI、NT-proBNP水平高于健康者，在脓毒症的检测中三种标志物的临床价值存在一定的差别，联合应用能使灵敏度、特异性及阳性预测率大幅提升，使患者可以早期诊断，早期治疗，有利于改善预后。

脓毒症；肌钙蛋白；肌酸激酶MB同工酶；血N末端B型钠尿肽前体

［Abstract］Objective To investigate the effect of the serum cTnI，CK-MB，NT-proBNP combined effects in chi1dren with sepsis test.Methods A tota1 of 60 chi1dren with sepsis who were se1ected from May 2015 to January 2016 in our hospita1.They were divided into the mi1d sepsis group（n=30）and the severe sepsis group（n=30）according to the disease degree，30 hea1th cases in the contro1 group，the objects were mached with sepsis chi1dren on the gender，age.CK-MB，cTnI，NT-proBNP 1eve1s of the three groups were detected，the sensitivity，specificity and positive predictive va1ue of the different detection indicators detected separate1y and combined detection were compared.Results CK-MB，cTnI，NT-proBNP 1eve1s of the severe sepsis group were higher than the mi1d sepsis group and the contro1 group，with significant difference among three groups（P＜0.05）；CK-MB，cTnI，NT-proBNP 1eve1s of the mi1d sepsis group were higher than the contro1 group，with significant difference between two groups（P＜0.05）.The sensitive of CK-MB，cTnI were higher than NT-proBNP，The specificity of cTnI，NT-proBNP were higher than CK-MB，the difference were statistica11y significant（P＜0.05）；The sensitivity，specificity and positive predictive va1ue of joint detection were higher than three indicators detected separate1y，the difference were statistica11y significant（P＜0.05）.Conclusion CK-MB，cTnI，NT-proBNP 1eve1s of the sepsis chi1dren is higher than hea1thy persons，certain differences exist in three c1inica1 va1ue of sepsis markers detected in，combined to make the sensitivity，specificity and positive forecasting rates increased dramatica11y，so that patients can be ear1y diagnosis，ear1y treatment，wi11 he1p to improve the prognosis.

［Key words］Sepsis；Troponin；Creatine kinase MB isoenzyme；Serum N-termina1 B-type natriuretic peptideprecursor

脓毒症是由感染引起的全身炎症反应综合征，具有病情发展速度快、病情重等特点，该病有较高的发病率及病死率，容易发展为多器官功能障碍，对患者的生活质量及生命安全造成严重的威胁［1］。……