重症加强护理病房老年心力衰竭伴肺部感染患者降钙素原水平与预后的关系  

The association between serum procalcitonin level and prognosis in elderly heart failure patients with pulmonary infection in intensive care unit

作　　者：张谨超[1] 张惠娟[1] 李玉妹[1] 崔朝勃[1] ZHANG Jin-chao ZHANG Hui-juan LI Yu-mei CUI Chao-bo(Department of Intensive Care Unit, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui 053000, Chin)

机构地区：[1]河北医科大学附属哈励逊国际和平医院重症医学科,衡水053000

出　　处：《中国急救复苏与灾害医学杂志》2016年第11期1092-1094,共3页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省衡水市科技局科研基金攻关项目（13024A）

摘　　要：目的探讨重症加强护理病房老年心力衰竭（心衰）伴肺部感染患者降钙素原水平的变化与预后的关系，为诊断及病情监测提供依据。方法选取120例老年心衰伴肺部感染患者为心衰伴肺部感染组，其中生存67例，死亡53例；随机选取同期单纯老年心衰患者85例为心衰非肺部感染组，其中生存62例，死亡23例。采用全自动荧光免疫分析仪测定降钙素原（procalcitonin，PCT）及N端脑钠肽前体（NT—proBNP）。结果心衰伴肺部感染组较心衰非肺部感染组血清PCT水平明显升高，差异有统计学意义[（5．2±0．12）ng／mLvs（0．4±0．31）ng／mL，P〈0．05]；NT—proBNP明显升高，差异有统计学意义[（658±23）pg／mLvs（312±52）pg／ml，P〈0．05]。死亡患者PCT水平明显高于生存患者，差异有统计学意义[（6．5±1．8）ng／mLVS（0．5±2．5）ng／mL，P〈0．05]。生存患者PCT水平异常率为22．5％，死亡患者为93．4％，差异有统计学意义（p〈0．05）。结论老年心衰伴肺部感染患者血清降钙素原水平明显升高。血清降钙素原可作为评价肺部感染的客观指标，对判断病情严重程度及预后有一定应用价值。Objective To discuss the association between serum procalcitonin （PCT） level and prognosis in elderly heart failure patients with pulmonary infection in intensive care unit （ICU） and provide evidence for the diagnosis and monitoring of heart failure. Methods A total of 120 elderly heart failure patients with pulmonary infection were set as a heart failure and pulmonary infection group, including 67 survival cases and 53 death cases. Meanwhile, another 85 elderly patients with heart failure alone were set as a heart failure group, including 62 survival cases and 23 death cases. Then, the levels of serum PCT and N terminal pro brain natriuretic peptide （NT-proBNP） were measured by an automatic fluorescence immunity analyzer. Results Compared with the heart failure group, the heart failure and pulmonary infection group produced remarkably higher levels of serum PCT[ （5.2±0.12） ng/ml vs 0.4±0.31 ）ng/ml, P〈 0.05] and NT-proBNP [（658±23） pg/ml vs （312±52） pg/ml, P〈 0.05]. Meanwhile, inereased amounts of PCT were found in the death eases than the survival cases [（6.5± 1.8） ng/ml vs （0.5±2.5） ng/ml, P 〈 0.05 ]. The abnormality rate was 22.3% within the survival eases and 92.2% within the death cases （P〈 0.05）. Conclusions Elderly heart failure patients with pulmonary infection present markedly increased levels of serum PCT. Therefore, serum PCT can be used as an objective index to evaluate pulmonary infection, which is helpful for the diagnosis and prognosis of diseases.

关 键 词：心力衰竭 肺炎 降钙素原 N端脑钠肽前体 

分 类 号：R563.1[医药卫生—呼吸系统]