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目的 探讨血清和肽素(Copeptin)与B型尿钠肽(BNP)及心肌肌钙蛋白I(cTnI)联合测定在脓毒症相关心肌损伤患者诊断及预后评估中的临床应用价值.方法 收集2013年5月—2017年5月入住苏州市立医院本部重症监护室(ICU)及急诊监护室(EICU)明确诊断脓毒症患者的临床病例资料,分为心肌损伤组(A组,n＝25)及非心肌损伤组(B组,n＝25),统计分析两组患者的Copeptin、cTnI、BNP、CRP水平以及APACHE Ⅱ评分差异,并进行相关性分析.结果 (1)A组血清Copeptin水平为(26.5±3.5)ng/mL,B组为(18.4±2.3)ng/mL,差异有统计学意义(P＜0.05);(2)A组血清cTnI、BNP水平为(12.5±1.3)ng/mL,(658±128)pg/mL,B组为(1.5±0.5)ng/mL,(150±35)pg/mL,差异均有统计学意义(P＜0.05);(3)A组APACHE Ⅱ评分为(28±12),B组为(22±8),差异无统计学意义(P＞0.05).(4)血清Copeptin水平与cTnI、BNP及APACHEⅡ评分呈正相关(P＜0.05).(5)所有纳入50 例患者7 例死亡(死亡率14.0%),A组5 例,B组2 例,死亡患者较存活患者Copeptin水平升高更显著(P＜0.05).结论 血清Copeptin在脓毒症并发心肌损伤患者中显著升高,联合测定Copeptin与心肌损伤标记物cTnI和BNP对脓毒症并发心肌损伤患者早期诊断及预后评估具有临床指导意义.“,”Objective To evaluate the clinical value of joint detection of Copeptin and B-type natriuretic peptide (BNP), cardiac troponin I (cTnI) in the diagnosis and prognosis of patients with septic myocardial injury. Methods The clinical data of sepsis patients admitted to ICU and EICU of Suzhou Municipal Hospital from May 2013 to May 2017 were collected and the patients were divided into two groups: myocardial injury group (group A, n＝25) and non-myocardial injury group (group B, n＝25). The Copeptin, cTnI, BNP, CRP level and APACHEⅡ score of the two groups were statistically analyzed and the correlation analysis was carried out. Results (1) The level of Copeptin in group A was higher than that in group B [(26.5±3.5) ng/mL vs. (18.4±2.3) ng/mL, P＜0.05]. (2)The levels of cTnI and BNP in group A were higher than those in group B [(12.5±1.3) ng/mL vs. (1.5±0.5) ng/mL, P＜0.01; (658±128) pg/mL vs. (150±35) pg/mL, P＜0.01]. (3)The APACHE Ⅱ score in group A was higher than that in group B, but there were no difference between two groups [(28±12) vs. (22±8), P＞0.05]. (4) Copeptin was positively correlated with BNP, APACHE Ⅱ score and cTnI (P＜0.05). (5) Of all the 50 patients, 7 cases died, 5 cases in group A and 2 cases in group B. Copeptin in dead patients elevated significantly (P＜0.05). Conclusion The level of Copeptin in serum is higher in patients with septic myocardial injury. The joint detection of Copeptin and myocardial injury markers have guiding significance for early diagnosis and prognosis of sepsis myocardial injury.