Effects of Hemoperfusion on Serum Cardiac Troponin T Concentrations Using Polymyxin B-Immobilized Fibers in Septic Patients Undergoing Hemodialysis
Effects of Hemoperfusion on Serum Cardiac Troponin T Concentrations Using Polymyxin B-Immobilized Fibers in Septic Patients Undergoing Hemodialysis
复制标题
使用多粘菌素 B 固定纤维进行血液灌流对血液透析脓毒症患者血清心肌肌钙蛋白 T 浓度的影响
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
H. Koide
中科院分区：
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作者：
Tsukasa Nakamura;C. Ushiyama;H. Shoji;H. Koide
我们研究了接受血液透析的脓毒症患者血清心肌肌钙蛋白T水平是否改变，以及多粘菌素B固定纤维（PMX-F）治疗是否影响这些水平。本研究包括14例败血症血液透析患者、14例无败血症血液透析患者和12例年龄匹配的健康对照。脓毒症血液透析患者的心肌肌钙蛋白T水平（0.56 ± 0.28 g/L）高于无脓毒症血液透析患者（0.16 ± 0.06 g/L，p < 0.01）和健康对照组（0.03 ± 0.01 g/L，p < 0.001）。14例败血症血液透析患者随机分配至两种治疗方法之一：PMX-F治疗（n = 7）或常规治疗（n = 7）。在用PMX-F治疗的患者中，血浆内毒素水平从46.6 ± 17.8 pg/ml显著降低至8.2 ± 2.4 pg/ml，p < 0.01，并且血清心肌肌钙蛋白T水平也从0.62 ± 0.30 g/L降低至0.26 ± 0.12 g/L，p < 0.05。在常规治疗的患者中，心肌肌钙蛋白T水平没有变化。这些数据表明，心肌肌钙蛋白T确实是升高败血症患者接受血液透析，并可能反映亚临床心肌细胞损伤。PMX-F可有效减少心肌损伤，部分原因是降低了血浆内毒素水平。
We investigated whether serum cardiac troponin T levels are altered in septic patients undergoing hemodialysis and whether polymyxin B-immobilized fiber (PMX-F) treatment affects these levels. Fourteen hemodialysis patients with sepsis, 14 hemodialysis patients without sepsis, and 12 age matched healthy controls were included in this study. Cardiac troponin T levels in hemodialysis patients with sepsis (0.56 ± 0.28 &mgr;g/L) were higher than levels in hemodialysis patients without sepsis (0.16 ± 0.06 &mgr;g/L, p < 0.01) and healthy control subjects (0.03 ± 0.01 &mgr;g/L, p < 0.001). The 14 hemodialysis patients with sepsis were randomly assigned to one of two treatment approaches: PMX-F treatment (n = 7) or conventional treatment (n = 7). Plasma endotoxin levels were significantly reduced from 46.6 ± 17.8 pg/ml to 8.2 ± 2.4 pg/ml, p < 0.01, in patients treated with PMX-F, and serum cardiac troponin T levels were also reduced from 0.62 ± 0.30 &mgr;g/L to 0.26 ± 0.12 &mgr;g/L, p < 0.05. Cardiac troponin T levels were unchanged in patients under conventional treatment. These data suggest that cardiac troponin T is indeed elevated in septic patients undergoing hemodialysis and may reflect subclinical myocardial cell damage. PMX-F is effective in reducing myocardial damage, in part, due to reducing plasma endotoxin levels.