血清降钙素、脑钠肽、心肌肌钙蛋白Ⅰ与老年肺炎病情严重程度的关系  

Relationship of serum calcitonin,brain natriuretic peptide and cardiac troponin Ⅰ with disease severity of senile pneumonia

作　　者：康林 祝莹 高芸 黄瑾 李润洁 KANG Lin;ZHU Ying;GAO Yun;HUANG Jin;LI Runjie(Department of Geriatrics,Ya′an People′s Hospital in Sichuan Province,Ya′an,Sichuan,625000)

机构地区：[1]四川省雅安市人民医院老年医学科,四川雅安625000

出　　处：《实用临床医药杂志》2023年第17期93-96,共4页Journal of Clinical Medicine in Practice

基　　金：四川省卫生和计划生育委员会科研课题(17PJ034);四川省医学科研青年创新课题(Q16081)。

摘　　要：目的 探讨降钙素(PCT)、脑钠肽(BNP)、心肌肌钙蛋白Ⅰ(cTnⅠ)水平与老年肺炎患者病情严重程度之间的关系。方法 选取收治的肺炎患者166例纳入研究组,选取同期在医院体检的健康者50例纳入对照组。比较2组血清PCT、BNP、cTnⅠ水平。根据肺炎严重度指数(PSI)将研究组患者分为轻度组88例、中度组49例和重度组29例。比较3组患者血清PCT、BNP、cTnⅠ水平及PSI评分;分析PCT、BNP、cTnⅠ与PSI评分的相关性。采用受试者工作特征(ROC)曲线评估PCT、BNP、cTnⅠ水平对重度肺炎的预测价值。结果 研究组血清PCT、BNP、cTnⅠ水平高于对照组,差异有统计学意义(P<0.05)。轻度组、中度组与重度组患者的血清PCT、BNP、cTnI水平随病情严重程度呈上升趋势,差异有统计学意义(P<0.05)。血清PCT、BNP、cTnI水平与PSI评分呈正相关(r=0.304,0.297,0.284;P<0.05)。ROC曲线显示,血清PCT、BNP、cTnI预测重度肺炎的曲线下面积(AUC)分别为0.627、0.781、0.637,三者联合预测的AUC为0.830。结论 老年肺炎患者的血清PCT、BNP、cTnⅠ水平异常上升,且与患者病情严重程度呈正相关。PCT、BNP、cTnⅠ联合预测老年重度肺炎的预测价值较佳。Objective To investigate the relationship of the levels of calcitonin(PCT),brain natriuretic peptide(BNP)and cardiac troponinⅠ(cTnI)with the severity of pneumonia in elderly patients.Methods A total of 166 patients with pneumonia were included in the study group,and 50 healthy patients who underwent physical examination in the hospital during the same period were included in the control group.The serum levels of PCT,BNP and cTnI were compared between the two groups.According to the pneumonia severity index(PSI),the study group was divided into mild group(88 cases),moderate group(49 cases)and severe group(29 cases).The levels of serum PCT,BNP and cTnI as well as PSI score were compared among the three groups;the correlations of PCT,BNP and cTnI with PSI score were analyzed.The predictive value of PCT,BNP and cTnI levels in severe pneumonia was evaluated by receiver operating characteristic(ROC)curve.Results The levels of PCT,BNP and cTnI in the study group were significantly higher than those in the control group(P<0.05).The levels of serum PCT,BNP and cTnI in the mild,moderate and severe groups were significantly increased with the severity of the disease(P<0.05).Serum PCT,BNP and cTnI levels were positively correlated with PSI scores(r=0.304,0.297,0.284;P<0.05).ROC curve showed that the area under the curve(AUC)of serum PCT,BNP and cTnI in predicting severe pneumonia were 0.627,0.781 and 0.637,respectively,and the AUC of the combined prediction was 0.830.Conclusion Serum PCT,BNP and cTnI levels in senile patients with pneumonia are increased abnormally,and are positively correlated with the severity of the patient′s disease.The combined prediction value of PCT,BNP and cTnI is better in predicting senile severe pneumonia.

关 键 词：降钙素原 脑钠肽 心肌肌钙蛋白Ⅰ 肺炎 

分 类 号：R563.1[医药卫生—呼吸系统] R446[医药卫生—内科学]