脓毒症患者中医证型与心功能、炎症指标及SOFA评分、mNUTRIC评分的相关性研究OA

Objective To investigate the correlation of traditional Chinese medicine(TCM)syndrome types with cardiac function indicators,inflammatory markers,and clinical scores in patients with sepsis.Methods A retrospective cohort study was conducted on 541 patients with sepsis admitted to the ICU,EICU,and NICU wards of Foshan Hospital of Traditional Chinese Medicine from January 2021 to December 2023.Intergroup differences in serum procalcitonin(PCT),C-reactive protein(CRP),N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),myoglobin(MYO),creatine kinase isoenzyme MB(CK-MB),Sequential Organ Failure Assessment(SOFA)score,modified Nutrition Risk in Critically Ill(mNUTRIC)score,and Acute Physiology and Chronic Health Evaluation II(APACHE II)score were analyzed across different TCM syndrome types,along with their relationship to cardiac function indicators.Results(1)Among the 541 sepsis patients,acute deficiency syndrome accounted for the highest proportion with 330 cases(61.0%),followed by toxic heat syndrome with 103 cases(19.0%),blood stasis syndrome with 67 cases(12.4%),and fu-organ qi obstruction syndrome with 41 cases(7.6%).(2)Statistically significant differences were observed in age,body temperature,and systolic blood pressure among patients with different TCM syndrome types(P＜0.05 or P＜0.01).Further analysis revealed that patients with acute deficiency syndrome had lower systolic blood pressure and body temperature compared to other syndrome types(P＜0.05);patients with toxic heat syndrome showed higher systolic blood pressure,body temperature,and 24-hour urine volume compared to other syndrome types(P＜0.05),and this syndrome type was associated with a younger patient population(P＜0.05).(3)Statistically significant differences were found in serum levels of PCT,CRP,NT-proBNP,cTnI,CK-MB,and SOFA scores among patients with different TCM syndrome types(P＜0.05 or P＜0.01).Compared with other syndrome types,patients with acute deficiency syndrome exhibited high serum NT-proBNP and MYO levels,as well as high SOFA and mNUTRIC scores(P＜0.05);patients with blood stasis syndrome showed high serum cTnI and CK-MB levels(P＜0.05);patients with fu-organ qi obstruction syndrome demonstrated low serum cTnI levels and SOFA scores(P＜0.05).(4)Logistic regression analysis and receiver operating characteristic(ROC)curve analysis revealed that cTnI was positively correlated with blood stasis syndrome(P=0.016);CK-MB and cTnI,either alone or in combination,demonstrated diagnostic value for blood stasis syndrome.Conclusion Patients with sepsis presenting with acute deficiency syndrome and blood stasis syndrome are more prone to developing sepsis-induced myocardial injury,warranting early identification and intervention.