血清HBP、pro-ADM及NT-proBNP对CHF患者肺部感染严重程度的诊断价值  

Diagnostic value of heparin-binding protein, pro-adrenomedullin, and N-terminal pro-brain natriuretic peptide in assessing the severity of pulmonary infection in patients with chronic heart failure

作　　者：严向锋 刘国龙 Yan Xiangfeng;Liu Guolong(Department of Intensive Care Medicine,Shaanxi Rehabilitation Hospital,Xi'an 710065,Shaanxi Province,China;Department of Intensive Care Medicine,Jingbian County People's Hospital,Yulin 718500,Shaanxi Province,China)

机构地区：[1]陕西省康复医院重症医学科,西安710065 [2]靖边县人民医院重症医学科,榆林718500

出　　处：《中国基层医药》2025年第2期177-183,共7页Chinese Journal of Primary Medicine and Pharmacy

基　　金：陕西省基础研究计划(2022JQ-855)。

摘　　要：目的探究血清肝素结合蛋白(HBP)、前肾上腺髓质素(pro-ADM)及B 型脑钠肽前体(NT-proBNP)对慢性心力衰竭(CHF)患者肺部感染严重程度的诊断价值。方法采用横断面研究, 选取陕西省康复医院2021年4月至2023年4月收治的CHF肺部感染患者100例为感染组, 根据肺部感染评分(CPIS)分为轻度组(n=43)、中度组(n=31)、重度组(n=26), 另选取该院同期收治的CHF肺部未感染患者50例为对照组。比较不同组别患者的一般资料、HBP、pro-ADM及NT-proBNP水平, 采用logistic分析CHF患者发生肺部感染的影响因素, 并利用Pearson分析相关指标的相关性。结果重度组HBP[(36.59±4.15)μg/L]、pro-ADM[(3.69±0.85)nmoL/L]、NT-proBNP[(9.63±1.61)μg/L]、中度组[(33.09±3.67)μg/L、(3.24±0.58)nmoL/L、(8.15±1.42)μg/L]和轻度组[(29.12±3.38)μg/L、(2.65±0.37)nmoL/L、(6.67±0.68)μg/L]三组间比较, 差异均有统计学意义(F=34.41、26.27、48.53, 均P < 0.05)。感染组HBP[(32.29±3.25)μg/L]、pro-ADM[(3.09±0.41)nmoL/L]、NT-proBNP[(7.89±0.92)μg/L]水平均高于对照组[(26.54±2.47)μg/L、(2.32±0.32)nmoL/L、(5.65±0.82)μg/L](t=12.05、12.61、18.17, 均P < 0.05)。logistic分析表明, 吸烟史、美国纽约心脏病协会心功能分级、合并糖尿病、HBP、pro-ADM及NTpro-BNP均是CHF患者发生肺部感染的影响因素(均P < 0.05)。Pearson分析显示, 患者的HBP、pro-ADM及NT-proBNP水平与CPIS评分均呈显著正相关(r=0.581、0.540、0.653, 均P < 0.05)。结论血清HBP、pro-ADM及NTpro-BNP水平对CHF患者肺部感染严重程度有着良好的预测价值。Objective:To investigate the diagnostic value of heparin-binding protein(HBP),pro-adrenomedullin(pro-ADM),and N-terminal pro-brain natriuretic peptide(NT-proBNP)in assessing the severity of pulmonary infection in patients with chronic heart failure(CHF).Methods:A cross-sectional study was conducted on 100 patients with CHF and pulmonary infection who were admitted to Shaanxi Rehabilitation Hospital between April 2021 and April 2023.According to clinical pulmonary infection score,the patients were classified into mild(n=43),moderate(n=31),and severe(n=26)groups.Additionally,50 CHF patients without pulmonary infection,who were admitted during the same period,were included in the control group.General demographic data,as well as levels of HBP,pro-ADM,and NT-proBNP were compared among the groups.Logistic regression analysis was performed to identify the factors associated with the occurrence of pulmonary infection in CHF patients,while Pearson correlation analysis was used to assess the correlations among these indicators.Results:The levels of HBP,pro-ADM,and NT-proBNP in the severe group were(36.59±4.15)μg/L,(3.69±0.85)nmoL/L,and(9.63±1.61)μg/L,respectively.In the moderate group,the levels were(33.09±3.67)μg/L,(3.24±0.58)nmoL/L,and(8.15±1.42)μg/L,respectively.In the mild group,the levels were(29.12±3.38)μg/L,(2.65±0.37)nmoL/L,and(6.67±0.68)μg/L,respectively.Significant differences were found in the levels of HBP,pro-ADM,and NT-proBNP among the three groups(F=34.41,26.27,48.53,all P<0.05).The levels of HBP,pro-ADM,and NT-proBNP in patients with CHF and pulmonary infection were(32.29±3.25)μg/L,(3.09±0.41)nmoL/L,and(7.89±0.92)μg/L,respectively,which were significantly higher than those in healthy controls[(26.54±2.47)μg/L,(2.32±0.32)nmoL/L,(5.65±0.82)μg/L,t=12.05,12.61,18.17,all P<0.05].Logistic regression analysis showed that a history of smoking,New York Heart Association(NYHA)functional classification,the presence of diabetes,as well as levels of HBP,pro-ADM,and NT-proBNP,were all factors in

关 键 词：心力衰竭 呼吸道感染 肺炎 肾上腺髓质素 利钠肽 脑 预测 诊断 

分 类 号：R563.1[医药卫生—呼吸系统] R541.6[医药卫生—内科学]