Objective To investigate the dynamic changes of blood lactate (Lac), cardiac troponin I (cTnI), cardiac troponin T (cTnT) and coagulation indexes in patients with sepsis and their relationship with disease severity and survival. Methods 129 patients with sepsis who were treated in our hospital from March 2019 to March 2022 were retrospectively selected. They were divided into the two groups according to whether shock occurred within 24 hours after admission. 48 patients with shock were septic shock group, and 81 patients without shock were septic shock group. The peripheral blood Lac, cTnI, cTnT, activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen (Fib) were examined. Results The scores of Lac, cTnI, cTnT, APTT, PT, TT and APACHE Ⅱ in the septic shock group were (9.10±1.08) mmol/L, (10.40±1.18) μ g/L, (11.18±1.72) μ g/L, (41.58±6.03) s, (16.30±2.18) s, (20.50±2.71) s and (17.05±2.50) respectively, which were significantly higher than those in the sepsis group (P<0.05), while the Fib was (2.51±0.81) g/L, which was significantly lower than that in the sepsis group (P<0.05). Lac, cTnI, cTnT, APTT, PT, TT were positively correlated with APACHE Ⅱ score (P<0.05), while Fib was positively correlated with APACHE Ⅱ score (P<0.05). Lac, cTnI, cTnT, APTT, PT and TT in septic shock and sepsis patients at 24h and 72h after treatment were significantly higher than those before treatment (P<0.05), while Fib was significantly lower than those before treatment (P<0.05). The changes of Lac, cTnI, cTnT, APTT, PT, TT and Fib in dead patients with septic shock before and after treatment were significantly higher than those in survivors (P<0.05). The area under the ROC curve of predicting death in septic shock patients by the change values of Lac, cTnI, cTnT, PT, TT and Fib before and after treatment in septic shock patients was 0.940, 0.684, 0.688, 0.724, 0.726 and 0.690, respectively (P<0.05).Conclusion The more serious the sepsis patients are, the worse their blood lactic acid, troponin and blood coagulation indicators are, and the indicators continued to worsen before and after treatment. The changes of blood lactic acid, troponin and coagulation indexes before and after treatment have certain application value in predicting the prognosis of septic shock patients