降钙素原与超敏C反应蛋白联合胱抑素C对老年急性左心衰竭合并肺部感染的临床价值  

The clinical value of procalcitonin,hypersensitive C-reactive protein combined with cystatin C in elderly patients with acute left heart failure and pulmonary infection

作　　者：芦志雁[1] 周俊阁[1] 韩萍[2] 支攀攀 LU Zhiyan;ZHOU Junge;HAN Ping;ZHI Panpan(Department of Geriatrics,Beijing Haidian Hospital Beijing 100080,China)

机构地区：[1]北京市海淀医院老年内科,100080 [2]北京市海淀医院心血管内科,100080

出　　处：《心肺血管病杂志》2023年第1期18-22,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市海淀医院面上项目(KYM2018001)。

摘　　要：目的:观察老年急性左心衰竭(ALHF)合并肺部感染患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)和胱抑素C(CysC)水平变化,并分析其对ALHF合并肺部感染的诊断价值。方法:选取2019年1月至2021年6月期间,入院治疗的ALHF老年患者98例,未合并肺部感染者44例为非感染组,ALHF合并肺部感染54例为感染组,另选健康体检者40例为对照组。检测并比较三组的血清PCT、hs-CRP和CysC水平,分析其与肺部感染的关系。结果:ALHF感染组和非感染组的血清PCT、hs-CRP和CysC水平均显著高于对照组,且感染组显著高于非感染组(P<0.05)。ALHF感染组的血清PCT、hs-CRP和CysC水平呈显著正相关性(P<0.05)。三项指标联合检测对肺部感染的诊断特异度较单项检测明显升高(P<0.05),且阳性预测值及阴性预测值均显著高于PCT、hs-CRP检测(P<0.05)。结论:老年ALHF患者血清PCT、hs-CRP和CysC水平明显升高,且其水平与ALHF伴发肺部感染有关,检测血清PCT、hs-CRP联合CysC可能有助于评估老年ALHF患者是否合并肺部感染。Objective:To observe and analyze the changes of serum procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP)and cystatin C(CysC)levels in elderly patients with acute left heart failure(ALHF)and pulmonary infection and to investigate its diagnostic value for ALHF complicated with pulmonary infection.Methods:98 patients with ALHF who admitted to the hospital from January 2019 to June 2021 were selected.44 patients without lung infection as the non-infected group,54 ALHF patients with pulmonary infection as the infected group,and 40 patients with healthy physical examination were selected as the control group.The serum PCT,hs-CRP and CysC levels of the three groups were detected and compared,and their relationship with lung infection was analyzed.Results:The serum PCT,hs-CRP and CysC levels of the ALHF infected group and the non-infected group were significantly higher than those of the control group,and the infected group was significantly higher than the non-infected group(P<0.05).In the ALHF infection group,there was significant positive correlation between serum PCT,hs-CRP and CysC levels(P<0.05).The diagnostic specificity of the combined detection of the three indicators for pulmonary infection was significantly higher than that of the single detection(P<0.05),and the positive predictive value and negative predictive value were significantly higher than those of PCT and hs-CRP detection(P<0.05).Conclusions:Serum levels of PCT,hs-CRP and CysC levels in elderly patients with ALHF are significantly increased,and their levels are related to ALHF with pulmonary infection.Detection of serum PCT,hs-CRP and CysC could act as effective indicators for diagnosing pulmonary infection in elderly patients with ALHF.

关 键 词：急性左心衰竭 肺部感染 降钙素原 超敏C反应蛋白 胱抑素C 

分 类 号：R54[医药卫生—心血管疾病]