NT-proBNP/BNP比值、CHE、IL-6与心力衰竭合并肺部感染患者心功能和感染指标的关系
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摘要
目的研究N末端B型利钠肽原/B型利钠肽(NT-proBNP/BNP)比值、血清胆碱酯酶(CHE)、白细胞介素-6(IL-6)与心力衰竭合并肺部感染患者心功能和感染指标的关系。方法将2016年2月至2018年2月在成都医学院第一附属医院收治的心力衰竭合并肺部感染患者60例纳入试验组,选取同期我院收治的单纯心力衰竭患者60例纳入对照组。比较两组患者NT-proBNP/BNP比值、CHE、IL-6水平、心功能指标与感染指标水平,并作相关性分析。结果试验组NT-proBNP/BNP比值、IL-6水平高于对照组,CHE水平低于对照组(P<0.05)。与对照组相比,试验组左室射血分数(LVEF)降低,而左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESDVI)升高(P<0.05)。试验组白细胞计数、中性粒细胞百分比、淋巴细胞比率均高于对照组(P<0.05)。Pearson相关性分析显示:NT-proBNP/BNP比值、IL-6与LVEF呈负相关(P<0.05),与LVEDVI、LVESDVI、白细胞计数、中性粒细胞百分比、淋巴细胞比率呈正相关(P<0.05);而CHE与LVEF呈正相关(P<0.05),与LVEDVI、LVESDVI、白细胞计数、中性粒细胞百分比、淋巴细胞比率呈负相关(P<0.05)。结论 NT-proBNP/BNP比值、CHE、IL-6与心力衰竭合并肺部感染患者心功能和感染指标密切相关,临床上可通过联合检测上述三项指标水平,以判断患者心功能与感染情况。
Objective To study the correlation of NT-proBNP/BNP ratio,serum cholinesterase(CHE),interleukin-6(IL-6)with cardiac function and infection indicators in patients with cardiac failure complicated with pulmonary infection.Methods A total of 60 patients with cardiac failure complicated with pulmonary infection admitted to The First Affiliated Hospital of Chengdu Medical College from February of 2016 to February of 2018 were included into the research group,and the other 60 patients with cardiac failure were enrolled into the control group.The NT-proBNP/BNP ratio,CHE level,IL-6 level,cardiac function indexes and levels of infection indicators were compared between the two groups and the correlation analysis was conducted.Results The NTproBNP/BNP ratio and IL-6 level were significantly higher(P<0.05)and the CHE level was significantly lower(P<0.05)in the research group than in the control group.Compared with the control group,the left ventricular ejection fraction(LVEF)decreased significantly(P<0.05)while the left ventricular end-diastolic volume index(LVEDVI)and left ventricular end-systolic volume index(LVESDVI)increased significantly(P<0.05).The white blood cell count,neutrophilic granulocyte percentage and lymphocyte ratio in the research group were significantly higher than those in the control group(P<0.05).The results of Pearson correlation analysis showed that the NT-proBNP/BNP ratio and IL-6 level were negatively correlated with LVEF(P<0.05)and positively correlated with LVEDVI,LVESDVI,white blood cell count,neutrophilic granulocyte percentage and lymphocyte ratio(P<0.05),while CHE was positively correlated with LVEF(P<0.05)and negatively correlated with LVEDVI,LVESDVI,white blood cell count,neutrophilic granulocyte percentage and lymphocyte ratio(P<0.05).Conclusion NT-proBNP/BNP ratio,CHE and IL-6 are closely related to cardiac function and infection indicators in patients with cardiac failure complicated with pulmonary infection.Clinically,the cardiac function and infection of patients can be judged by the combined detection of the above three indicators.
Objective To study the correlation of NT-proBNP/BNP ratio,serum cholinesterase(CHE),interleukin-6(IL-6)with cardiac function and infection indicators in patients with cardiac failure complicated with pulmonary infection.Methods A total of 60 patients with cardiac failure complicated with pulmonary infection admitted to The First Affiliated Hospital of Chengdu Medical College from February of 2016 to February of 2018 were included into the research group,and the other 60 patients with cardiac failure were enrolled into the control group.The NT-proBNP/BNP ratio,CHE level,IL-6 level,cardiac function indexes and levels of infection indicators were compared between the two groups and the correlation analysis was conducted.Results The NTproBNP/BNP ratio and IL-6 level were significantly higher(P<0.05)and the CHE level was significantly lower(P<0.05)in the research group than in the control group.Compared with the control group,the left ventricular ejection fraction(LVEF)decreased significantly(P<0.05)while the left ventricular end-diastolic volume index(LVEDVI)and left ventricular end-systolic volume index(LVESDVI)increased significantly(P<0.05).The white blood cell count,neutrophilic granulocyte percentage and lymphocyte ratio in the research group were significantly higher than those in the control group(P<0.05).The results of Pearson correlation analysis showed that the NT-proBNP/BNP ratio and IL-6 level were negatively correlated with LVEF(P<0.05)and positively correlated with LVEDVI,LVESDVI,white blood cell count,neutrophilic granulocyte percentage and lymphocyte ratio(P<0.05),while CHE was positively correlated with LVEF(P<0.05)and negatively correlated with LVEDVI,LVESDVI,white blood cell count,neutrophilic granulocyte percentage and lymphocyte ratio(P<0.05).Conclusion NT-proBNP/BNP ratio,CHE and IL-6 are closely related to cardiac function and infection indicators in patients with cardiac failure complicated with pulmonary infection.Clinically,the cardiac function and infection of patients can be judged by the combined detection of the above three indicators.
引文
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[6]孙润锋,陈云,杨华,等.痰热清注射液对心力衰竭伴肺部感染患者血清胆碱酯酶及免疫功能的影响研究[J].中华医院感染学杂志,2017,27(22):5087-5090.
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[9]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中国实用乡村医生杂志,2015(4):3-5.
[10]王胜强,李吉刚,赵爱荣,等.重组脑钠肽对急性失代偿性心力衰竭患者炎症因子及肾素系统的影响[J].现代生物医学进展,2017,17(16):3072-3075.
[11]Pugliese N R,Fabiani I,La Carrubba S,et al.Prognostic value of a tissue doppler index of systodiastolic function in patients with asymptomatic heart failure[J].J Cardiovasc Echogr,2018,28(2):95-100.
[12]李川,杨丽丽,魏晓华,等.血清PCT对心力衰竭并发肺部感染患者抗感染疗效与生存状况的影响[J].检验医学与临床,2018,15(2):173-175.
[13]许旭东,马剑锋,林欣庚,等.急诊内科危重症心力衰竭患者合并肺部感染的危险因素分析[J].临床肺科杂志,2018,23(3):515-518.
[14]Bornheimer R,Shea K M,Sato R,et al.Risk of exacerbation following pneumonia in adults with heart failure or chronic obstructive pulmonary disease[J].PLoS One,2017,12(10):e0184877.
[15]夏世念,赵金,谌杰.血清BNP、D-二聚体、PCT和IL-10联合检测对心力衰竭并发肺部感染的诊断作用[J].标记免疫分析与临床,2017,24(12):1399-1402.
[16]孟婷婷,夏文胜,夏继辉,等.老年心力衰竭患者肺部感染的影响因素研究[J].实用心脑肺血管病杂志,2016,24(11):25-28.
[17]韩芬,杨晓,王运登,等.N-端脑钠肽前体与炎症因子在心力衰竭合并肺部感染患者中的临床意义[J].中华医院感染学杂志,2018,28(4):499-503.
[18]张建国,丁明,袁娜娜.BNP及炎症因子与肺部感染合并心衰患者心功能的关系研究[J].中国循证心血管医学杂志,2017,9(11):1357-1359.
[19]施金虎,孙辉明.万古霉素与头孢他啶对老年心力衰竭合并肺部感染患者炎症因子及降钙素原的影响[J].药物评价研究,2017,40(11):1614-1617.
[20]Ohkuma T,Jun M,Woodward M,et al.Cardiac stress and inflammatory markers as predictors of heart failure in patients with type 2 diabetes:the ADVANCE trial[J].Diabetes Care,2017,40(9):1203-1209.
[21]隋世华.甘露聚糖肽联合舒巴坦治疗老年心力衰竭并肺部感染患者的临床疗效及其对心功能和免疫功能的影响研究[J].实用心脑肺血管病杂志,2017,25(2):34-37.
[2]Pereira J,Ribeiro A,Ferreira-Coimbra J,et al.Is there a C-reactive protein value beyond which one should consider infection as the cause of acute heart failure[J].BMCCardiovasc Disord,2018,18(1):40.
[3]余微,程幼夫,张汝,等.老年心力衰竭合并肺部感染患者BNP、NT-proBNP、PCT、NT-proBNP/BNP比值水平变化及意义[J].四川医学,2017,38(11):1314-1317.
[4]Cho J,Park I B,Lee K,et al.Statin has more protective effects in AMI patients with higher plasma BNP or NT-proBNP level,but not with lower left ventricular ejection fraction[J].J Cardiol,2018,71(4):375-381.
[5]胡晓飞,许世佳,孙红,等.三种生物学标志物在心力衰竭患者诊断中的应用[J].中华老年心脑血管病杂志,2018,20(2):161-163.
[6]孙润锋,陈云,杨华,等.痰热清注射液对心力衰竭伴肺部感染患者血清胆碱酯酶及免疫功能的影响研究[J].中华医院感染学杂志,2017,27(22):5087-5090.
[7]Sato T,Yamauchi H,Suzuki S,et al.Serum cholinesterase is an important prognostic factor in chronic heart failure[J].Heart Vessels,2015,30(2):204-210.
[8]单瑞,杨培根.老年慢性心衰患者血清胆汁酸水平与炎症因子及心室重构的关系[J].天津医药,2018,46(1):42-45.
[9]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中国实用乡村医生杂志,2015(4):3-5.
[10]王胜强,李吉刚,赵爱荣,等.重组脑钠肽对急性失代偿性心力衰竭患者炎症因子及肾素系统的影响[J].现代生物医学进展,2017,17(16):3072-3075.
[11]Pugliese N R,Fabiani I,La Carrubba S,et al.Prognostic value of a tissue doppler index of systodiastolic function in patients with asymptomatic heart failure[J].J Cardiovasc Echogr,2018,28(2):95-100.
[12]李川,杨丽丽,魏晓华,等.血清PCT对心力衰竭并发肺部感染患者抗感染疗效与生存状况的影响[J].检验医学与临床,2018,15(2):173-175.
[13]许旭东,马剑锋,林欣庚,等.急诊内科危重症心力衰竭患者合并肺部感染的危险因素分析[J].临床肺科杂志,2018,23(3):515-518.
[14]Bornheimer R,Shea K M,Sato R,et al.Risk of exacerbation following pneumonia in adults with heart failure or chronic obstructive pulmonary disease[J].PLoS One,2017,12(10):e0184877.
[15]夏世念,赵金,谌杰.血清BNP、D-二聚体、PCT和IL-10联合检测对心力衰竭并发肺部感染的诊断作用[J].标记免疫分析与临床,2017,24(12):1399-1402.
[16]孟婷婷,夏文胜,夏继辉,等.老年心力衰竭患者肺部感染的影响因素研究[J].实用心脑肺血管病杂志,2016,24(11):25-28.
[17]韩芬,杨晓,王运登,等.N-端脑钠肽前体与炎症因子在心力衰竭合并肺部感染患者中的临床意义[J].中华医院感染学杂志,2018,28(4):499-503.
[18]张建国,丁明,袁娜娜.BNP及炎症因子与肺部感染合并心衰患者心功能的关系研究[J].中国循证心血管医学杂志,2017,9(11):1357-1359.
[19]施金虎,孙辉明.万古霉素与头孢他啶对老年心力衰竭合并肺部感染患者炎症因子及降钙素原的影响[J].药物评价研究,2017,40(11):1614-1617.
[20]Ohkuma T,Jun M,Woodward M,et al.Cardiac stress and inflammatory markers as predictors of heart failure in patients with type 2 diabetes:the ADVANCE trial[J].Diabetes Care,2017,40(9):1203-1209.
[21]隋世华.甘露聚糖肽联合舒巴坦治疗老年心力衰竭并肺部感染患者的临床疗效及其对心功能和免疫功能的影响研究[J].实用心脑肺血管病杂志,2017,25(2):34-37.
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