中国现代医学杂志2025，Vol.35Issue(21)：86-91,6.DOI:10.3969/j.issn.1005-8982.2025.21.014
cTnI、ApoA-Ⅰ联合冠状动脉CT血管成像对脓毒症相关心肌损伤的评估价值分析
Evaluation value of cTnI and ApoA-Ⅰ combined with coronary artery computed tomography angiography for myocardial injury in patients with sepsis
摘要
Abstract
Objective To investigate the evaluation value of cardiac troponin I(cTnI),apolipoprotein A-Ⅰ(ApoA-Ⅰ),and coronary artery computed tomography angiography for myocardial injury in septic patients.Methods A total of 85 septic patients admitted to our hospital from January 2022 to December 2024 were enrolled and divided into a myocardial injury group(n=52)and a non-myocardial injury group(n=33).All patients underwent coronary artery computed tomography angiography,and serum levels of cTnI and ApoA-Ⅰ were measured.Logistic regression was used to analyze risk factors for myocardial injury,and ROC curves were applied to assess the predictive value of combined cTnI and ApoA-Ⅰ.Results Comparison between the myocardial injury group and the non-myocardial injury group showed that the differences in the rates of non-stenotic deep myocardial bridges and the rates of no obvious stenosis or plaques were statistically significant as determined by the chi-square test(P<0.05).There were also statistically significant differences in the levels of cTnI and ApoA-Ⅰ between the myocardial injury group and the non-myocardial injury group as tested by the t-test(P<0.05).Specifically,the serum cTnI level in the myocardial injury group was higher than that in the non-myocardial injury group,while the ApoA-Ⅰ level in the myocardial injury group was lower than that in the non-myocardial injury group.Logistic regression analysis revealed that the presence of no obvious stenosis or plaques[O^R=21.284(95%CI:1.612,281.105)],non-stenotic deep myocardial bridges[O^R=56.436(95%CI:1.823,1 736.132)],elevated serum cTnI[O^R=16.754(95%CI:1.702,164.978)],and decreased ApoA-Ⅰ[O^R=1 085.952(95%CI:3.811,309 451.857)]were risk factors for myocardial injury in patients with sepsis(P<0.05).The ROC curve analysis indicated that the combined detection of serum cTnI and ApoA-Ⅰ for predicting myocardial injury in sepsis patients had a sensitivity of 83.9%(95%CI:0.719,0.931)and a specificity of 92.6%(95%CI:0.798,0.993).Conclusion Coronary artery computed tomography angiography characteristics differ significantly between septic patients with and without myocardial injury.The combination of cTnI,ApoA-Ⅰ,and coronary artery computed tomography angiography improves early identification of myocardial injury in sepsis.关键词
脓毒症/心肌损伤/心肌肌钙蛋白I/载脂蛋白A-Ⅰ/冠状动脉CT血管成像Key words
sepsis/myocardial injury/cardiac troponin I/apolipoprotein A-Ⅰ/coronary artery computed tomography angiography分类
临床医学引用本文复制引用
柯纯华,黄四云..cTnI、ApoA-Ⅰ联合冠状动脉CT血管成像对脓毒症相关心肌损伤的评估价值分析[J].中国现代医学杂志,2025,35(21):86-91,6.基金项目
广东省基础与应用基础研究基金项目(No:2024A1515010534) （No:2024A1515010534）
