心力衰竭合并肺部感染患者心肌酶谱和炎性细胞因子水平变化及NPPA基因多态性分布  

Changes of myocardial enzyme profile and inflammatory cytokines and NPPA gene polymorphism in patients with heart failure complicated with pulmonary infection

作　　者：张家会[1] 彭民建[1] 方英[2] 杨萍 李毓龙 郭燕红[1] ZHANG Jia-hui;PENG Min-jian;FANG Ying;YANG Ping;LI Yu-long;GUO Yan-hong(Jianyang People's Hospital,Chengdu,Sichuan 641400,China)

机构地区：[1]简阳市人民医院心内科二,四川成都641400 [2]简阳市人民医院医院感染管理科,四川成都641400 [3]简阳市人民医院检验科,四川成都641400

出　　处：《中华医院感染学杂志》2023年第24期3714-3718,共5页Chinese Journal of Nosocomiology

基　　金：四川省科研基金资助项目(2022LH0311)。

摘　　要：目的 研究心力衰竭合并肺部感染患者心肌酶谱、炎性细胞因子水平变化及利钠肽前体A(NPPA)基因多态性分布。方法 回顾性选取2021年1月-2022年12月简阳市人民医院收治的33例心力衰竭合并肺部感染患者为感染组,43例心力衰竭未合并肺部感染患者为非感染组,选取同期在医院进行体检的84名健康体检者为健康对照组,统计三组一般资料、血清心肌酶谱、炎性细胞因子水平,采用Pearson相关分析血清心肌酶谱与炎性细胞因子的相关性,统计心力衰竭患者NPPA基因多态性分布情况。结果 感染组、非感染组、健康对照组血清肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)、肌酸激酶(CK)、乳酸盐脱氢酶(LDH)、N末端脑钠肽前体(NT-proBNP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平呈逐渐降低趋势,组间比较差异具有统计学意义(P<0.05);Pearson相关分析结果显示,血清CK-MB、AST、CK、LDH、NT-proBNP与血清PCT、TNF-α、CRP、IL-6呈正相关关系(P<0.05);感染组rs5067基因型CC占比低于非感染组,TT占比高于非感染组(P<0.05)。结论 肺部感染的发生可引起心力衰竭患者血清心肌酶谱、炎性细胞因子水平变化,两者水平呈正相关关系,同时心力衰竭是否合并肺部感染患者NPPA基因rs5067基因型分布存在差异。OBJECTIVE To study the changes of myocardial enzyme profile and inflammatory cytokines, as well as natriuretic peptide precursor A(NPPA) gene polymorphisms in patients with heart failure complicated with pulmonary infection. METHODS A total of 33 patients with heart failure combined with pulmonary infection admitted to the Jianyang People′s Hospital from Jan 2021 to Dec 2022 were enrolled as the infection group, and 43 patients with heart failure without lung infection were in the non-infection group;84 healthy volunteers under physical examination in the hospital during the same period were in the healthy control group. The general data, serum myocardial enzyme profile and inflammatory cytokine levels among the three groups were analyzed. Pearson correlation was used to analyze the correlation between serum myocardial enzyme profile and inflammatory cytokine, and the distribution of NPPA gene polymorphism in patients with heart failure was analyzed. RESULTS The levels of serum creatine kinase isoenzyme(CK-MB), aspartate aminotransferase(AST), creatine kinase(CK), lactate dehydrogenase(LDH), N-terminal brain natriuretic peptide precursor(NT-proBNP), procalcitonin(PCT), tumor necrosis factor-α(TNF-α), C-reactive protein(CRP) and interleukin-6(IL-6) in the infected group, the non-infected group and the healthy control group gradually decreased, and the difference among groups was significant(P<0.05). Pearson correlation analysis showed that serum CK-MB, AST, CK, LDH and NT-proBNP levels were significantly positively correlated with serum PCT, TNF-α, CRP and IL-6 levels(P<0.05). The proportion of rs5067 genotype CC in the infected group was lower than that in the the non-infected group, while the proportion of TT in the non-infected group was higher than that in the infected group(P<0.05). CONCLUSION The occurrence of pulmonary infection could cause variation levels of serum myocardial enzyme profile and inflammatory cytokine in patients with heart failure, and there was significant positive correlation between

关 键 词：心力衰竭 肺部感染 心肌酶谱 炎性细胞因子 利钠肽前体A 基因多态性 

分 类 号：R563.1[医药卫生—呼吸系统]