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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NTpro BNP,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。
Objective To investigate the role of serum cTnI, CK-MB and NT-proBNP in the detection of sepsis in children. Methods The clinical data of 60 sepsis children treated in our hospital from May 2015 to January 2016 were divided into mild sepsis group (n = 30) and severe sepsis group n = 30). Thirty healthy children who were matched for sex, age and sepsis in our hospital were randomly selected as the control group. The levels of CK-MB, cTnI and NT-proBNP in the three groups were compared with each other Sensitivity, specificity and positive predictive value of single and combined detection of markers. Results The levels of CK-MB, cTnI and NT-proBNP in severe sepsis group were higher than those in mild sepsis group and control group (P <0.05). CK-MB and cTnI in mild sepsis group , NT-proBNP levels higher than the control group, the difference was statistically significant (P <0.05). The sensitivity of CK-MB and cTnI was higher than NTpro BNP, the specificity of cTnI and NT-proBNP was higher than that of CK-MB (P <0.05). The sensitivity, specificity and positive predictive value The markers were tested separately higher, the difference was statistically significant (P <0.05). Conclusion The serum levels of CK-MB, cTnI and NT-proBNP in children with sepsis are higher than those in healthy people. There is a certain difference in the clinical value of the three markers in the detection of sepsis. The combination of sensitivity, specificity and positive The predictive rate increased significantly, so that patients can early diagnosis and early treatment, is conducive to improving the prognosis.