HBDH、PCT、PLT、NT-pro-BNP联合检测在重症肺炎合并心肌损伤患者中的应用  

Application of combined detection of HBDH,PCT,PLT and NT⁃pro⁃BNP in patients with severe pneumonia and myocardial injury

作　　者：高歌 王松[2] 郭琳红 GAO Ge;WANG Song;GUO Linhong(Department of Intensive Care Medicine,Fuyang Cancer Hospital,Fuyang,Anhui,China,236000;Department of Medical Oncology,Fuyang Cancer Hospital,Fuyang,Anhui,China,236000)

机构地区：[1]阜阳市肿瘤医院重症医学科,安徽阜阳236000 [2]阜阳市肿瘤医院肿瘤内科,安徽阜阳236000

出　　处：《分子诊断与治疗杂志》2023年第6期934-938,共5页Journal of Molecular Diagnostics and Therapy

基　　金：中华国际医学交流基金会先声临床科研专项基金项目(z-2014-06-2201)。

摘　　要：目的探讨α-羟丁酸脱氧酶(HBDH)、降钙素原(PCT)、血小板(PLT)、N端脑钠肽前体(NT-proBNP)联合检测在重症肺炎合并心肌损伤患者中的应用。方法选取2018年6月至2022年6月阜阳市肿瘤医院重症医学科重症肺炎患者92例作为研究对象,按照重症肺炎患者的病情严重程度分为危重组(n=43)和非危重组(n=49),并按照患者是否发生心肌损伤分为心肌损伤组(发生心肌损伤,n=29)和对照组(未发生心肌损伤,n=63)。比较危重组和非危重组的HBDH、PCT、PLT、NT-pro-BNP水平。心肌损伤组和对照组的一般资料以及HBDH、PCT、PLT、NT-pro-BNP水平。采用Pearson相关性分析分析血清HBDH、PCT、PLT、NT-pro-BNP水平与重症肺炎患者并发心肌损伤的相关性,采用多因素Logistic回归分析重症肺炎患者并发心肌损伤的影响因素,受试者工作特征曲线(ROC)分析血清HBDH、PCT、PLT、NT-pro-BNP水平对重症肺炎患者并发心肌损伤的预测价值。结果危重组的HBDH、PCT、PLT、NT-pro-BNP水平明显高于非危重组,差异具有统计学意义(t=16.605、21.305、2.259、34.320,P<0.05)。心肌损伤组患有低钾血症的患者数、呼吸衰竭的例数、HBDH、PCT、PLT、NT-pro-BNP水平均明显高于对照组,差异具有统计学意义(χ^(2)=7.101、4.046,t=4.993、15.316、2.263、24.172,P<0.05)。Pearson相关性分析显示,HBDH、PCT、PLT、NT-pro-BNP均于重症肺炎患者并发心肌损伤呈正相关(P<0.05)。多因素回归分析显示,HBDH、PCT、PLT、NT-pro-BNP是重症肺炎患者并发心肌损伤的独立危险因素(P<0.05)。ROC曲线分析结果显示,HBDH、PCT、PLT、NT-pro-BNP单独以及联合检测诊断重症肺炎患者并发心肌损伤的曲线下面积(AUC)分别为0.793、0.807、0.836、0.842、0.907。结论HBDH、PCT、PLT、NT-pro-BNP联合检测对重症肺炎患者是否合并心肌损伤具有较高的诊断价值,可为临床诊断提供参考依据。Objective To explore the application of combined detection ofα⁃hydroxybutyrate de⁃oxygenase(HBDH),procalcitonin(PCT),platelets(PLT),and N⁃terminal pro⁃brain natriuretic peptide(NT⁃proBNP)in patients with severe pneumonia complicated with myocardial injury.Methods Ninety⁃two patients with severe pneumonia in the Department of Intensive Care Medicine of Fuyang Cancer Hospital from June 2018 to June 2022 were selected as the research objects.According to the severity of severe pneumonia patients,they were divided into the critical group(n=43)and the non⁃critical group(n=49),and divided into the myocardial injury group according to whether the patients had myocardial injury(myocardial injury,n=29)and the control group(no myocardial injury,n=63).The levels of HBDH,PCT,PLT and NT⁃pro⁃BNP in critical and non⁃critical groups were compared.General data and levels of HBDH,PCT,PLT and NT⁃pro⁃BNP were ob⁃tained in the myocardial injury group and the control group.Pearson correlation analysis was used to analyze the correlation between serum HBDH,PCT,PLT,NT⁃pro⁃BNP levels and myocardial injury in patients with se⁃vere pneumonia.Multivariate Logistic regression was used to analyze the influencing factors of myocardial inju⁃ry in patients with severe pneumonia.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of serum HBDH,PCT,PLT and NT⁃pro⁃BNP levels in patients with severe pneumonia compli⁃cated with myocardial injury.Results The levels of HBDH,PCT,PLT and NT⁃pro⁃BNP in the critical group were significantly higher than those in the non⁃critical group,and the differences were statistically significant(t=16.605,21.305,2.259,34.320,P<0.05).The number of patients with hypokalemia,respiratory failure cas⁃es,HBDH,PCT,PLT and NT⁃pro⁃BNP levels in the observation group were significantly higher than those in the control group,and the differences were statistically significant(χ^(2)=7.101,4.046,t=4.993,15.316,2.263,24.172,P<0.05).Pearson corr

关 键 词：α-羟丁酸脱氧酶 降钙素原 血小板 N端脑钠肽前体 重症肺炎 心肌损伤 

分 类 号：R563.1[医药卫生—呼吸系统] R542.2[医药卫生—内科学]