Objective: To investigate the risk factors of death in patients with sepsis. Methods: From August 2014 to August 2016, 58 patients suffering sepsis in intensive care unit (ICU) of the People's Liberation Army 105 Hospital were prospectively analyzed.All patients were divided into survival group (n=39) and death group (n=19). The patients' gender, age, past medical history, acute physiology and chronic health system Ⅱ(APACHE Ⅱ), Sequential organ failure assessment(SOFA) score, B-type natriuretic peptide, lactate, procalcitonin, left ventricle EF%, right ventricle Tei index were measured within 24 h after admission in ICU.Logistic regression analysis was used to evaluate the risk factors of death in septic patients.the hospital mortality of sepsis was assessed by receiver operating character (ROC) curves. Results: The hospital mortality rate of sepsis was 32.8% (19/58). Logistic regression analysis showed that SOFA score [OR=2.34, 95%CI: 1.069-5.258, P<0.01], cTnI[OR=1.21, 95%CI: 1.017-1.437, P=0.032], Tei index[OR=1.56, 95%CI: 1.082-2.263, P=0.017]. The APACHEⅡ, SOFA score, lactic acid, cTnI, Tei index and cTnI combined with Tei index predicted the hospital mortality of sepsis with the area under ROC curve (AUC) of 0.821, 0.848, 0.790, 0.756, 0.962, 0.982, respectively. Conclusion: Tei index and cTnI may be the independent risk factors of sepsis in patients with sepsis, and the incidence of major adverse cardiac events was high.
目的： 探讨脓毒症患者预后的危险因素。 方法： 2014年8月至2016年8月，前瞻性研究入住解放军一五医院重症监护室符合脓毒症诊断标准的患者58例。根据转归将患者分为生存组(39例)和死亡组(19例)，24 h内完成患者的性别、年龄、合并基础疾病、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、序贯器官衰竭估计(SOFA)评分、肌钙蛋白I(cTnI)、B型脑钠肽(BNP)、乳酸、降钙素原、左心室射血分数(EF)、右心室心肌做功(Tei)指数指标被收集。采用Logistic回归分析评估脓毒症患者死亡危险因素，并通过受试者工作特征曲线(ROC)评价各种危险因素评估脓毒症死亡的预测价值。 结果： 脓毒症患者院内病死率32.8%(19/58)。Logistic回归分析表明SOFA评分[OR＝2.34，95%CI：1.069～5.258，P<0.01]、cTnI[OR＝1.21，95%CI：1.017～1.437，P＝0.032]和Tei指数[OR＝1.56，95%CI：1.082～2.263，P＝0.017]均是脓毒症患者死亡的独立危险因素；APACHEⅡ、SOFA评分、乳酸、cTnI、右心室Tei指数及cTnI与右心室Tei指数联合指标的ROC曲线下面积分别是0.821、0.848、0.790、0.756、0.962、0.982。 结论： 脓毒症患者的不良心脏事件发生率高，cTnI和右心室Tei指数可能是患者的独立危险因素。.
Keywords: Cardiac biomakers; Risk factors; Sepsis; Tei index.