老年慢性心力衰竭患者肺部感染的危险因素及其对PCT、NT-proBNP及氧化应激指标的影响  

Risk factors of pulmonary infection in elderly patients with chronic heart failure and their effects on PCT, NT-probNP and oxidative stress indexes

作　　者：王国玉[1] 巴春贺[1] 李彤[1] 王浩宇[2] 徐志超 曹俊杰[1] WANG Guoyu;BA Chunhe;LI Tong;WANG Haoyu;XU Zhichao;CAO Junjie(Department of Geriatrics,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China;Department of Radiology,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China)

机构地区：[1]承德医学院附属医院老年病科,河北承德067000 [2]承德医学院附属医院放射科,河北承德067000

出　　处：《中南医学科学杂志》2023年第1期110-113,共4页Medical Science Journal of Central South China

基　　金：承德市科学技术研究与发展计划项目(202109A037)。

摘　　要：目的 分析老年慢性心力衰竭患者肺部感染的危险因素及其对降钙素原(PCT)、B型脑钠肽前体(NT-proBNP)、氧化应激指标的影响。方法 选取60例老年慢性心力衰竭合并肺部感染者为心力衰竭感染组,无肺部感染者60例为单纯心力衰竭组。检测两组患者血液中PCT、NT-proBNP及氧化应激指标水平,单因素及多因素Logistic回归分析老年慢性心力衰竭患者肺部感染的危险因素。结果 单因素分析结果显示,心功能分级、吸烟史、糖尿病、高血压、肾功能不全及侵入性操作均与老年慢性心力衰竭患者肺部感染有关(P<0.05)。多因素Logistic回归分析结果显示,心功能分级高、有吸烟史、合并糖尿病及接受侵入性操作均为导致老年慢性心力衰竭患者肺部感染的危险因素(P<0.05)。与单纯心力衰竭组相比,心力衰竭感染组患者血清PCT、NT-proBNP及丙二醇(MDA)水平升高(P<0.05),超氧化物歧化酶(SOD)与谷胱甘肽化物酶(GSH-Px)水平降低(P<0.05)。随着肺部感染程度加重,患者血清PCT、NT-proBNP及MDA水平递增(P<0.05),SOD与GSH-Px水平递减(P<0.05)。结论 老年慢性心力衰竭患者肺部感染的发生与心功能分级、吸烟史、糖尿病及侵入性操作等相关,同时肺部感染可使老年慢性心力衰竭患者心功能降低,氧化应激反应增强。Aim To analyze the risk factors of pulmonary infection in elderly patients with chronic heart failure and their effects on procalcitonin(PCT), B-type brain natriuretic peptide precursor(NT-proBNP), and oxidative stress indicators. Methods Sixty elderly patients with heart failure complicated with lung infection were selected as the heart failure infection group, and 60 patients with chronic heart failure without lung infection were selected as the simple heart failure group. The levels of PCT, NT-proBNP and oxidative stress in the blood of the two groups were measured, and univariate and multivariate Logistic regression analysis were used to analyze the risk factors of lung infection in elderly patients with chronic heart failure. Results Univariate analysis showed that cardiac function grade, smoking history, diabetes, hypertension, renal insufficiency, and invasive procedures were all associated with pulmonary infection in elderly patients with chronic heart failure(P<0.05). Multivariate Logistic regression analysis showed that high cardiac function grade, smoking history, diabetes mellitus, and invasive procedures were all risk factors for pulmonary infection in elderly patients with chronic heart failure(P<0.05). Compared with the simple heart failure group, serum PCT, NT-proBNP and propylene glycol(MDA) levels were increased(P<0.05), and superoxide dismutase(SOD) and glutathione enzyme(GSH-Px) levels decreased in the heart failure infection group(P<0.05). With the aggravation of lung infection, serum PCT, NT-proBNP and MDA levels in patients with heart failure were increased(P<0.05), SOD and GSH-Px levels decreased(P<0.05). Conclusion The occurrence of pulmonary infection in elderly patients with chronic heart failure is related to high cardiac function grade, smoking history, diabetes mellitus, and invasive procedures, while lung infection can reduce cardiac function and enhance oxidative stress levels in elderly patients with chronic heart failure.

关 键 词：老年慢性心力衰竭 肺部感染 降钙素原 B型脑钠肽前体 氧化应激 

分 类 号：R541.6[医药卫生—心血管疾病] R563.1[医药卫生—内科学]