肌钙蛋白和脑钠肽对高龄重症肺炎患者预后的影响  

Effects of plasma cardiac troponin Ⅰ and brain natriuretic peptide levels on prognosis of very old patients with severe pneumonia

作　　者：许丹[1] 徐冬 田海军[1] XU Dan;XU Dong;TIAN Hai-Jun(Department of Cadre’s Ward, Chinses PLA Hospital No.161, Wuhan 430010, China)

机构地区：[1]解放军第161医院干部病房,武汉430010

出　　处：《中华老年多器官疾病杂志》2018年第1期43-46,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨高龄重症肺炎患者血浆肌钙蛋白(c Tn I)和脑钠肽(BNP)水平对预后的临床价值。方法选择2013年1月至2017年1月在解放军第161医院干部病房住院的高龄(≥80岁)肺炎患者93例。按病情严重程度,分为两组:重症肺炎组(n=40)和普通肺炎组(n=53)。重症肺炎组根据患者住院期间的预后情况又分为两个亚组:死亡组(n=19)和好转组(n=21)。对重症肺炎组(入院第1、3、5和7天)和普通肺炎组(入院第1天)患者的血浆c Tn I和BNP水平进行检测,比较各组患者血浆c Tn I和BNP水平。采用SPSS 23.0软件进行数据处理。依据数据类型,组间比较分别采用t检验、方差分析或χ~2检验。结果重症肺炎组的血浆c Tn I[99.35(39.95,159.30)vs 7.00(4.40,11.65)pg/ml]和BNP[566.10(326.53,935.13)vs49.10(24.50,88.30)pg/ml]水平均显著高于普通肺炎组(P<0.05)。与第1天比较,好转组患者第3、5和7天的血浆c Tn I和BNP水平均显著降低(P<0.05),死亡组第3、5和7天的血浆c Tn I和BNP水平均显著增高(P<0.05)。好转组患者第1、3、5和7天的血浆c Tn I和BNP水平均显著低于死亡组,差异有统计学意义(P<0.05)。结论 c Tn I和BNP水平可作为高龄重症肺炎合并心肌损伤患者早期评估及判断预后的辅助指标。ObjectiveTo determine the effects of cardiac troponin I(cTnI)and brain natriuretic peptide(BNP)on the prognosis of the very old patients with severe pneumonia(SP).MethodsA total of93very old patients(≥80years old)with severe pneumonia admitted to our department from January2013to January2017were recruited in this study.According to the severity of the disease,they were divided into the SP group(n=40)and ordinary pneumonia group(n=53).The former group was further assigned into death subgroup(n=19)and improvement subgroup(n=21).The plasma cTnI and BNP levels were measured for all the SP patients on days1,3,5and7after admission,and in the ordinary pneumonia group on day1after admission.SPSS statistics23.0was adopted for data processing.Student’s t test or Chi square test was employed for different data types.ResultsThe plasma levels of cTnI[9935(39.95,159.3)vs7.00(4.40,11.65)pg/ml]and BNP[566.10(326.53,935.13)vs49.10(24.50,88.30)pg/ml]were significantly higher in SP group than in the ordinary pneumonia group(P<0.05).Compared with the values on day1,the plasma levels of cTnI and BNP were decreased in the improvement group on days3,5and7(P<005),while those in the death group were increased on days3,5and7(P<0.05).The levels were obviously lower in the improvement group on days1,3,5and7when compared with the death group(P<0.05).ConclusionThe plasma levels of cTnI and BNP could be used as adjuvant indicators for assessment of myocardial damage and prognosis in very old patients with SP.

关 键 词：老年人 80以上 肺炎 预后 肌钙蛋白 脑钠肽 

分 类 号：R592[医药卫生—老年医学] R563.1[医药卫生—内科学]