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急性左心衰竭合并肺部感染患者血清相关指标检测及其诊断价值

Detection of indicators for patients with acute left ventricular failure complicated with pulmonary infection and and its diagnostic value

    摘要
  • 摘要:
      目的  研究急性左心衰竭合并肺部感染患者血清C反应蛋白(CRP)、降钙素原(PCT)和心功能指标B型钠尿肽(BNP)、高敏肌钙蛋白T(hs-cTnT)检测水平及其诊断价值。
      方法  将本院收治的80例急性左心衰竭患者依据患者临床表现、实验室检查结果分为无合并肺部感染的非感染组(n=38)和合并肺部感染的感染组(n=42), 另外选取80例同期在本院行健康体检的健康志愿者为对照组(n=80)。检测患者血清炎症因子(CRP、PCT)和心功能指标(BNP、hs-cTnT)水平，观察3组CRP、PCT、BNP、hs-cTnT指标水平差异及以上指标与急性左心衰竭合并肺部感染患者心功能的关系，并分析以上指标在急性左心衰竭合并肺部感染患者中的诊断价值。
      结果  感染组血清CRP、PCT、BNP、hs-cTnT水平均显著高于对照组和非感染组(P < 0.05); 非感染组血清CRP、PCT、BNP、hs-cTnT水平均显著高于对照组(P < 0.05)。感染组患者的心功能分级与血清CRP、PCT、BNP、hs-cTnT水平呈正相关(r=0.755 8、0.796 1、0.921 6、0.899 5, P < 0.05)。以CRP≥15 ng/L、PCT≥0.15 ng/mL、BNP≥870 ng/L、hs-cTnT≥8 ng/mL结果为阳性标准，感染组患者血清CRP、PCT、BNP、hs-cTnT的阳性率均显著高于对照组和非感染组(P < 0.05)。
      结论  急性左心衰竭患者体内血清炎症因子和心功能指标均可作为诊断早期合并肺部感染的重要指标，且其水平的高低可在一定程度上反映患者肺部感染的严重程度，能够指导急性左心衰患者早期合并肺部感染时的治疗。

     

    Abstract:
      Objective  To detect the levels of serum C-reactive protein (CRP), procalcitonin (PCT), type B natriuretic peptide (BNP) and high sensitive troponin T (hs-cTnT) in patients with acute left heart failure complicated with pulmonary infection, and its diagnostic value.
      Methods  A total of 80 patients with acute left heart failure admitted to our hospital were divided into non-infectious group (n=38) without pulmonary infection and infectious group (n=42) with pulmonary infection according to the clinical manifestations and laboratory results. Eighty healthy volunteers who underwent health examination in our hospital at the same time were selected as control group (n=80). The levels of serum inflammatory factors such as CRP, PCT, and cardiac function indexes such as BNP and hs-cTnT were measured. The differences of CRP, PCT, BNP and hs-cTnT levels between the two groups and their relationship with cardiac function in patients with acute left heart failure complicated with pulmonary infection were observed. Diagnostic value of above indicators for patients were explored.
      Results  The levels of CRP, PCT, BNP and hs-cTnT in the infected group were the highest, and lowest in the control group(P < 0.05). There were positive correlation between cardiac function grading and serum CRP, PCT, BNP, hs-cTnT levels (r=0.755 8, 0.796 1, 0.921 6, 0.899 5, respectively, P < 0.05). The positive rates of CRP, PCT, PCT, BNP, and hs-cTnT in infected group were significantly higher than those in control group and non-infected group taking CRP≥15 ng/L, PCT≥0.15 ng/mL, BNP≥870 ng/L, hs-cTnT≥8 ng/mL as positive criteria (P < 0.05).
      Conclusion  The levels of serum inflammatory factors such as CRP, PCT and cardiac function indicators such as BNP and hs-cTnT in patients with acute left heart failure can be used as important indicators for the diagnosis of early pulmonary infection, and above indicators can reflect the severity of pulmonary infection, and can be the guidance of treatment pulmonary infection in patients with acute left heart failure.

     

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