血清氨基末端脑钠肽前体及降钙素原浓度对老年心力衰竭合并肺炎患者预后的评估作用  

Application of serum concentrations of N-terminal pro-brain natriuretic peptide and procalcitonin in prognosis assessment of elderly patients with heart failure and pneumonia

作　　者：徐沛演 Xu Pei-yan(Guangzhou Huadu District People′s Hospital,Guangzhou 510800,China)

机构地区：[1]广州市花都区人民医院,广州510800

出　　处：《岭南心血管病杂志》2020年第4期444-446,451,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨血清氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)及降钙素原(procalcitonin,PCT)浓度对老年心力衰竭合并肺炎患者预后的评估作用。方法按随机数字表法选取2018年2月至2018年12月广州市花都区人民医院老年心力衰竭合并肺炎患者30例,将这些患者作为研究组;另按随机数字表法选取同期本院健康体检人员30名作为对照组。比较血清NT-proBNP及PCT浓度在研究组与对照组、研究组不同心功能分级亚组患者及研究组不同预后亚组患者的差异。结果研究组患者的血清NTproBNP及PCT浓度高于对照组,差异有统计学意义[(6207.3±133.3)pg/mL vs.(84.0±16.8)pg/mL,P<0.05;(3.7±1.2)ng/mL vs.(0.3±0.1)ng/mL,P<0.05]。研究组心功能分级Ⅱ级、Ⅲ级、Ⅳ级亚组患者的血清NT-pro BNP浓度分别为(3042.1±142.5)pg/mL、(6131.1±110.6)pg/mL、(6789.4±112.1)pg/mL,血清PCT浓度分别为(3.1±1.0)ng/mL、(3.6±1.2)ng/mL、(4.4±1.4)ng/mL。研究组心功能分级Ⅲ级、Ⅳ级亚组患者的血清NT-pro BNP及PCT浓度均显著高于Ⅱ级亚组患者,而Ⅳ级亚组患者的血清NT-pro BNP及PCT浓度又均显著高于Ⅲ级亚组患者,差异均有统计学意义(P<0.05)。研究组30例患者中,存活26例,死亡4例,存活率、病死率分别为86.7%、13.3%。死亡患者的血清NT-proBNP及PCT浓度均显著高于存活患者,差异有统计学意义[(7845.1±167.0)pg/mL vs.(5943.3±162.1)pg/mL,P<0.05;(4.8±1.6)ng/mL vs.(3.1±1.0)ng/mL,P<0.05]。结论血清NT-proBNP及PCT浓度在老年心力衰竭合并肺炎患者预后评估中的应用价值高。Objectives To explore the application of serum concentrations of N-terminal pro-brain natriuretic peptide(NT-proBNP)and procalcitonin(PCT)in prognosis assessment of elderly patients with heart failure and pneumonia.Methods Thirty elderly patients with heart failure and pneumonia in Guangzhou Huadu District People’s Hospital from February 2018 to December 2018 were randomly selected as study group.Thirty healthy persons in our hospital for physical examination during the same period were randomly selected as control group.Differences of serum concentrations of NT-proBNP and PCT between study group and control group,among patients in study group with different cardiac function grades and with different prognosis were compared.Results Serum concentrations of NT-proBNP and PCT of the study group were significantly higher than those of control group[(6207.3±133.3)pg/mL vs.(84.0±16.8)pg/mL,P<0.05;(3.7±1.2)ng/mL vs.(0.3±0.1)ng/mL,P<0.05].Serum concentrations of NT-proBNP in patients with cardiac function gradeⅡ,ⅢandⅣin study group were(3042.1±142.5)pg/mL,(6131.1±110.6)pg/mL,(6789.4±112.1)pg/mL,and serum concentrations of PCT were(3.1±1.0)ng/mL,(3.6±1.2)ng/mL,(4.4±1.4)ng/mL,respectively.Serum concentrations of NT-proBNP and PCT in patients with cardiac function gradeⅢandⅣwere significantly higher than those in patients with gradeⅡ(P<0.05),while serum concentrations of NT-proBNP and PCT in patients with gradeⅣwere significantly higher than those in patients with gradeⅢ(P<0.05).Of the 30 patients in study group,26 survived and 4 died.The survival rate and mortality were 86.7%and 13.3%,respectively.Serum concentrations of NTproBNP and PCT in dead patients were significantly higher than those in surviving patients[(7845.1±167.0)pg/mL vs.(5943.3±162.l)pg/mL,P<0.05;(4.8±1.6)ng/mL vs.(3.1±1.0)ng/mL,P<0.05].Conclusions Serum concentrations of NT-proBNP and PCT in prognostic assessment of elderly patients with heart failure and pneumonia are of high value.

关 键 词：心力衰竭 肺炎 氨基末端脑钠肽前体 降钙素原 预后 老年 

分 类 号：R541.6[医药卫生—心血管疾病]