BNP及炎症因子与肺部感染合并心衰患者心功能的关系研究  

Relationship among BNP, inflammatory factors and heart function in patients with pulmonary infection complicated by heart failure

作　　者：张建国[1] 丁明[2] 袁娜娜[1] Zhang Jianguo;Ding Ming;Yuan Nana(Intensive Care Unit, Affiliated Hospital of Jiangsu University, Zhenjiang 212013,China)

机构地区：[1]江苏大学附属医院重症医学科,镇江212013 [2]江苏大学附属医院呼吸内科,镇江212013

出　　处：《中国循证心血管医学杂志》2017年第11期1357-1359,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的观察肺部感染合并心力衰竭(心衰,HF)患者的血浆脑钠肽(BNP)及血清炎症因子水平变化,探讨其与心功能的关系。方法选择2014年2月~2016年10月于江苏大学附属医院住院的肺部感染合并慢性HF患者72例作为A组,另选取单纯HF患者90例为B组,我院同期健康体检者40例为C组。检测和比较三组的血浆BNP、血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,并研究BNP、IL-6、TNF-α与NYHA分级的关系。结果治疗前A、B组的血浆BNP及血清IL-6、TNF-α水平均显著高于C组,且A组显著高于C组(P<0.05);治疗后A、B组的血浆BNP及血清IL-6、TNF-α水平均显著降低,但A组仍显著高于B组(P<0.05);A、B两组随NYHA心功能分级升高,BNP、IL-6、TNF-α浓度呈明显增高趋势,且A组明显高于B组相同分级(P<0.05);Spearman分析显示,A、B两组BNP、IL-6、TNF-α均与NYHA分级呈显著正相关性(P<0.05),且A组相关性更强。结论肺部感染合并HF患者存在明显的血浆BNP及血清IL-6、TNF-α高表达,且其与心功能损害密切相关,监测BNP及炎症因子变化对病情判断及治疗决策有重要指导意义。Objective To observe the changes of brain natriuretic peptide(BNP)and levels of serum inflammatory factors in patients with pulmonary infection complicated by heart failure(HF),and discuss relationship between these changes and heart function.Methods The patients with pulmonary infection complicated by HF were chosen into group A(n=72),those with only HF were chosen into group B(n=90)and health controls were chosen into group C(n=40)from Feb.2014to Oct.2016.The levels of BNP,interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected and compared in3groups.The relationship among BNP,IL-6,TNF-αand NYHA grading was studied.Results The levels of plasma BNP and serum IL-6and TNF-αwere significantly higher in groups A and B than those in group C,and were significantly higher in group A than those in group C before treatment(P<0.05).The levels of plasma BNP and serum IL-6and TNF-αdecreased significantly in groups A and B,but were still significantly higher in group A than those in group B after treatment(P<0.05).With the increase of NYHA grading,levels of plasma BNP and serum IL-6and TNF-αshowed significant ascending trends in groups A and B,and were significantly higher in group A than those in group B at the same NYHA grade(P<0.05).Spearman analysis showed that BNP,IL-6and TNF-αwere positively correlated to NYHA grading in groups A and B(P<0.05),which was more significant in group A.Conclusion The patients with pulmonary infection complicated by HF have higher expressions of plasma BNP and serum IL-6and TNF-α,which is closely correlated to heart dysfunction.The monitoring of changes of BNP and inflammatory factors has important guiding significance to judgment of patients’conditions and decision of therapies.

关 键 词：肺部感染 心力衰竭 脑钠肽 白细胞介素-6 肿瘤坏死因子-Α 

分 类 号：R541.61[医药卫生—心血管疾病]