老年慢性心衰肺部感染病原学及血清NT-proBNP、MMPs和炎症因子表达  

Etiological characteristics of pulmonary infection and expressions of serum NT-proBNP,MMPs,inflammatory factors in elderly patients with chronic heart failure

作　　者：杜军 李金銮[1] 王治[1] 孙秋[1] 魏凤莲[1] 谢红萍[1] DU Jun;LI Jin-luan;WANG Zhi;SUN Qiu;WEI Feng-lian;XIE Hong-ping(Nanjing Chest Hospital,Nanjing,Jiangsu 210000,China)

机构地区：[1]南京市胸科医院心内科,江苏南京210000

出　　处：《中华医院感染学杂志》2023年第17期2581-2584,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金项目(81570365)。

摘　　要：目的探讨老年慢性心衰合并肺部感染病原菌分布及血清N末端脑钠肽前体(NT-proBNP)、基质金属蛋白酶(MMPs)和炎症因子的表达水平.方法选择2020年1月-2022年12月于南京市胸科医院接受治疗的心力衰竭合并肺部感染患者120例作为感染组,另选取同期单纯心力衰竭患者120例作为非感染组,选择同期体检的健康老年人120名作为对照组.采集感染组患者痰液样本进行病原菌的培养与鉴定.检测并比较三组血清NT-proBNP、MMPs和炎症因子的表达水平.结果感染组患者痰液样本共分离病原菌187株,其中革兰阴性菌130株,占比69.52%,以大肠埃希菌为主;革兰阳性菌50株,占比26.74%,以肺炎链球菌为主;真菌7株,占比3.74%,以白假丝酵母为主.感染组患者血清MMPs、NT-proBNP和炎症因子[降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6指标水平均高于非感染组及对照组(P<0.05).结论绝大部分高龄慢性心衰合并肺部感染是由于感染革兰阴性菌所引起的,感染后MMPs、NT-proBNP和炎症因子水平均升高.OBJECTIVE To explore the distribution of pathogens and the expression levels of serum N-terminal brain natriuretic peptide(NT-proBNP),matrix metalloproteinases(MMPs)and inflammatory factors in the elderly patients with chronic heart failure.METHODS A total of 120 heart failure patients who were complicated with pulmonary infection and treated in Nanjing Chest Hospital from Jan 2020 to Dec 2022 were assigned as the infection group,meanwhile,120 patients who had simple heart failure were assigned as the non-infection group,and 12o healthy elderly people who received physical examination were chosen as the control group.The sputum specimens were collected from the patients of the infection group,pathogens were cultured and identified.The expression levels of serum NT-proBNP,MMPs and inflammatory factors were detected and compared among the three groups.RESULTS Totally 187 strains of pathogens were isolated from the sputum specimens of the patients in the infection group,130(69.52%)of which were gram-negative bacteria,50(26.74%)were gram-positive bacteria,and 7(3.74%)were fungi.Escherichia coli was the predominant species of the gram-negative bacteria;Streptococcus pneumoniae was dominant among the gram-positive bacteria;Candida albicans was dominant among the fungi.The levels of serum MMPs,NT-proBNP and inflammatory factors Eprocalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-6 J of the infection group were higher than those of the non-infection group and the control group.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from most of the elderly heart failure patients complicated with pulmonary infection.The levels of MMPs,NT-proBNP and inflammatory factors of the patients with infection are elevated.

关 键 词：老年人 心力衰竭 肺部感染 N末端脑钠肽前体 基质金属蛋白酶 病原菌 

分 类 号：R563[医药卫生—呼吸系统]