N-端脑钠肽前体与炎症因子在心力衰竭合并肺部感染患者中的临床意义  

Significance of serum N-terminal brain natriuretic peptide and inflammatory factors in patients with heart failure complicated with pulmonary infection

作　　者：韩芬[1] 杨晓[2] 王运登[1] 巩治华 徐文涛 张红艳[3] 

机构地区：[1]郑州铁路职业技术学院药学系(基础医学部)基础医学教研室,河南郑州451460 [2]河南中医药大学第一附属医院耳鼻喉科,河南郑州450000 [3]郑州铁路职业技术学院护理学院,河南郑州451460

出　　处：《中华医院感染学杂志》2018年第4期499-503,共5页Chinese Journal of Nosocomiology

摘　　要：目的探讨心力衰竭合并肺部感染患者血清N-端脑钠肽前体(NT-proBNP)、降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-1β(IL-1β)、IL-6和肿瘤坏死因子-α(TNF-α)水平与心肌功能的相关性分析。方法选取医院2014年3月-2017年3月心力衰竭患者228例为研究对象,根据是否发生肺部感染分为感染组86和非感染组142例,另选取同期健康体检者112例为对照组;采用酶偶联法检测谷草转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB),检测NT-proBNP、CRP、PCT、IL-1β、IL-6和TNF-α水平及与心功能的相关性。结果心力衰竭患者血清AST、LDH、CK、CKMB、NT-proBNP、PCT、CRP、IL-1β、IL-6和TNF-α水平高于对照组(P<0.05);感染组NT-proBNP、PCT、CRP、IL-1β、IL-6和TNF-α分别为(13.36±5.96)μg/L、(8.97±4.66)μg/L、(11.32±5.82)mg/L、(9.82±6.06)μg/L、(18.31±6.95)μg/L和(10.35±4.63)μg/L高于未感染组(P<0.05);感染组和未感染组血清AST、LDH、CK和CKMB差异无统计学意义。感染组患者血清NT-proBNP、PCT、CRP、IL-1β、IL-6和TNF-α水平与血清AST、LDH、CK和CKMB水平呈正相关(P<0.05);且心力衰竭纽约心脏病协会分级(NYHA)Ⅲ、Ⅳ级患者血清NT-proBNP、PCT、CRP、IL-1β、IL-6和TNF-α水平高于NYHAⅠ、Ⅱ级(P<0.05)。结论 NT-proBNP、PCT、CRP、IL-1β、IL-6和TNF-α水平在心力衰竭合并肺部感染患者较高,可反映患者的心肌功能和肺部感染情况,具有一定的临床价值。OBJECTIVE To discuss the correlation of serum N-terminal brain natriuretic peptide（NT-proBNP）and inflammatory factors[Procalcitonin（PCT）,C-reactive protein（CRP）,interleukin-1β（IL-1β）,interleukin-6（IL-6）and tumor necrosis factor-α（TNF-α）]in patients with heart failure complicated with pulmonary infection with cardiac function.METHODS A total of 228 cases of heart failure patients in hospital from Mar.2014 to Mar.2017 were selected as the research objects,and were divided into infection group（86 cases）and non-infection group（142 cases）according to whether there had pulmonary infection.A total of 112 cases of healthy physical examination in the same period were set as control group.Serum enzyme profile[aspartate aminotransferase（AST）,lactate dehydrogenase（LDH）,creatine kinase（CK）and creatine kinase MB（CKMB）]were measured by enzyme coupling,NT-proBNP,CRP,PCT,and levels of IL-1β,IL-6 and TNF-αwere detected,and their correlationwith cardiac function was analyzed.RESULTS Serum levels of AST,LDH,CK,CKMB,NT-proBNP,PCT,CRP,IL-1β,IL-6 and TNF-αin heart failure group were significantly higher than those in control group（P〈0.05）.Serum levels of NT-proBNP,PCT,CRP,IL-1β,IL-6 and TNF-αin infection group were（13.36±5.96）μg/L,（8.97±4.66）μg/L,（11.32±5.82）mg/L,（9.82±6.06）μg/L,（18.31±6.95）μg/L and（10.35±4.63）μg/L,which were significantly higher than those in non-infection group（P〈0.05）,while no significant differences was observed in AST,LDH,CK,CKMB between the above two groups.NT-proBNP,PCT,CRP,IL-1β,IL-6 and TNF-αwere significantly correlated with AST,LDH,CK,CKMB in infection group（P〈0.05）.Serum levels of NTproBNP,PCT,CRP,IL-1β,IL-6 and TNF-αin New York Heart Association（NYHA）classification Ⅲ and Ⅳgrades group were significantly higher than those in NYHA Ⅰ and Ⅱ grade groups（P〈0.05）.CONCLUSION NT-proBNP,PCT,CRP,IL-1β,IL-6 and TNF-αare increased in heart failure patients complicated with pulmonary in

关 键 词：心力衰竭 肺部感染 N-端脑钠肽前体 炎症因子 

分 类 号：R563.1[医药卫生—呼吸系统]