血浆N末端B型利钠肽原及降钙素原在ICU合并肺部感染患者中水平变化及临床意义  

Changes in Plasma N-terminal B-type Natriuretic Peptidogen and Procalcitonin Levels in Patients with Pulmonary Infections in the ICU and their Clinical Significance

作　　者：安然 李广明[1] 魏义胜[1] 李琤[2] AN Ran;LI Guang-ming;WEI Yi-sheng(The Second Department of Critical Care Medicine,Zhengzhou Sixth People’s Hospital,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州市第六人民医院重症医学二科,河南郑州450000 [2]郑州市第六人民医院肝硬化科,河南郑州450000

出　　处：《黑龙江医学》2023年第1期5-7,11,共4页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关计划项目(201902045)。

摘　　要：目的:研究血浆N末端B型利钠肽原(N-terminal pro-b-type natriuretic peptide,NT-proBNP)及降钙素原(procalcitonin,PCT)在ICU合并肺部感染患者中的水平变化及临床意义。方法:选取2018年9月—2019年10月郑州市第六人民医院收治的123例ICU患者的病历资料进行回顾性分析,根据美国胸科医师学会和危重病医学会共识会议的诊断标准,将其分为非感染组和感染组。其中非感染组58例,感染组65例。分析并比较两组患者血浆NT-proBNP、PCT的表达情况,并采用多元logistic回归分析影响ICU患者合并肺部感染的危险因素。结果:与非感染组相比,感染组的血浆NT-proBNP、PCT水平明显增加,差异有统计学意义(t=11.203、16.079,P<0.05);ICU患者合并肺部感染的发生率随着呼吸机使用、机械通气时间、吸烟史呈上升趋势;血浆NT-proBNP及PCT水平异常值显著升高,差异有统计学意义(t=19.949、4.391、4.709、73.705、96.813,P<0.05);呼吸机使用方式、机械通气时间、血浆NT-proBNP及PCT水平异常为影响ICU患者合并肺部感染的危险因素,差异有统计学意义(OR=2.13、2.08、2.16、2.40,P<0.05)。结论:血浆NT-proBNP及PCT在ICU合并肺部感染患者中显著升高,两者的水平异常为影响ICU合并肺部感染的独立危险因素,实时监测ICU患者NT-proBNP及PCT水平对预防肺部感染及改善患者预后具有重要临床意义。Objective:To study the changes of plasma N-terminal pro-b-type natriuretic peptide(NT-proBNP)and proprocalcitonin(PCT)levels and clinical significance in patients with ICU co-infection of lung.Methods:The medical record materials of 123 ICU patients admitted to the hospital from September 2018 to October 2019 were selected for retrospective analysis.According to the diagnostic criteria of the consensus conference of the American College of Chest Physicians and the Society of Critical Care Medicine,they were divided into a non-infected group of 58 cases and an infected group of 65 cases.The expressions of plasma NT-proBNP and PCT in the two groups were analyzed and compared,and multiple logistic regression was used to analyze the risk factors affecting the co-infection of lung in ICU patients.Results:Plasma NT-proBNP and PCT levels were significantly increased in the infected group compared with the non-infected group,with statistically significant differences(t=11.203,16.079,P<0.05).The incidence of co-infected lung infections in ICU patients tends to increase with ventilator use,duration of mechanical ventilation,and smoking history.Abnormal values of plasma NT-proBNP and PCT levels were significantly higher,with statistically significant differences(t=19.949,4.391,4.709,73.705,96.813,P<0.05).Ventilator use,duration of mechanical ventilation,and abnormal plasma NT-proBNP and PCT levels were risk factors for co-infection in ICU patients(OR=2.13,2.08,2.16,2.40,P<0.05).Conclusion:Plasma NT-proBNP and PCT are significantly elevated in patients with pulmonary infections in ICU,and abnormal levels of both are independent risk factors for pulmonary infections in ICU.Real-time monitoring of NT-proBNP and PCT levels in ICU patients has important clinical significance for preventing pulmonary infections and improving patient prognosis.

关 键 词：血浆N-末端B型利钠肽原 降钙素原 ICU合并肺部感染 应用价值 

分 类 号：R657.31[医药卫生—外科学]