老年慢性心力衰竭合并肺部感染患者血清NT-proBNP,CRP,CysC与心脏功能和预后不良的关系分析OA
Analysis of the Relationship Between Serum NT-proBNP,CRP,CysC with Cardiac Function and Poor Prognosis in Elderly Patients with Chronic Heart Failure Complicated by Pulmonary Infection
目的 探究老年慢性心力衰竭(CHF)合并肺部感染者血清N末端B型利钠肽原(NT-proBNP),C反应蛋白(CRP),胱抑素C(CysC)与心脏功能和预后不良的关系分析.方法 选取2023年6月至2024年6月我院就诊的48例老年CHF合并肺部感染患者(合并肺部感染组),再选取同期60例在我院治疗的单纯老年CHF患者(单纯CHF组),以及同期50例体检健康者(对照组).免疫荧光法检测血清NT-proBNP水平,全自动生化分析仪检测CysC水平,血细胞分析仪检测CRP水平.结果 合并肺部感染组和单纯CHF组患者血清NT-proBNP、CRP和CysC水平显著高于对照组,且合并肺部感染组高于单纯CHF组(P＜0.05).预后不良组的NT-proBNP、CRP、CysC、LVESD、LVEDD、HR水平显著高于预后良好组,LVEF水平显著低于预后良好组(P＜0.05).合并肺部感染者NT-proBNP、CRP和CysC水平与LVESD、LVEDD、HR呈正相关,同时与LVEF呈负相关(P＜0.05).预后不良组和预后良好组患者心力衰竭病程、NYHA心功能分级比较,差异有统计学意义(P＜0.05);且心力衰竭病程、NYHA心功能分级、NT-proBNP、CRP和CysC均是影响合并肺部感染者预后的危险因素(P＜0.05).血清NT-proBNP、CRP和CysC联合预测合并肺部感染者预后的AUC分别为0.974,优于各自单独预测(Z联合-NT-proBNP=2.323、Z联合-CRP=2.002、Z联合-CysC=2.090,P=0.020、0.045、0.037).结论 合并肺部感染者血清NT-proBNP、CRP和CysC水平升高,三者与合并肺部感染者的心脏功能以及预后不良状况有关,联合预测对合并肺部感染者预后不良具有较高的预测价值.
Objective To investigate the relationship between serum N-terminal pro-B-type natriuretic peptide(NT-proB-NP),C-reactive protein(CRP),cystatin C(CysC),cardiac function,and poor prognosis in elderly patients with chronic heart fail-ure(CHF)complicated by pulmonary infection.Methods 48 elderly CHF complicated pulmonary infected patients(complicated pulmonary infection group)were selected between June 2023 and June 2024,and then 60 elderly CHF patients(CHF only group)and 50 healthy individuals(control group)in the same period were selected.Immunofluorescence assay was applied to detect ser-um NT-proBNP.Fully automatic biochemical analyzer was applied to detect CysC.The blood cell analyzer was used to detect CRP.Results Serum NT-proBNP,CRP,and CysC in the complicated pulmonary infection group and the simple CHF group were signifi-cantly higher than those in control group,and the complicated pulmonary infection group was higher than simple CHF group(P＜0.05).NT-proBNP,CRP,CysC,LVESD,LVEDD,and HR in poor prognosis group were significantly higher than those in good prognosis group,while LVEF was significantly lower than that in the good prognosis group(P＜0.05).NT-proBNP,CRP,and CysC in CHF patients with pulmonary infection were positively correlated with LVESD,LVEDD,and HR,and negatively correlated with LVEF(P＜0.05).There was a significantly difference in the duration of heart failure and NYHA cardiac functional grading be-tween poor prognosis group and good prognosis group(P＜0.05).The duration of heart failure,NYHA functional classification,NT-proBNP,CRP,and CysC were all risk factors that affected the prognosis of CHF patients with pulmonary infection(P＜0.05).The AUC value of the combination of serum NT-proBNP,CRP,and CysC for predicting the prognosis of CHF patients with pulmo-nary infection was 0.974,which were better than their individual predictions(Z combination-NT-proBNP=2.323,Z combination-CRP=2.002,Z combination-CysC=2.090,P=0.020,0.045,0.037).Conclusion Serum NT-proBNP,CRP,and CysC would be all elevated in pa-tients with CHF complicated by pulmonary infection.Three are associated with cardiac function and poor prognosis in patients with CHF complicated by pulmonary infection.Combined prediction has high predictive value for poor prognosis in patients with CHF complicated by pulmonary infection.
谭化;李佳红;张秀敬;贾营;李娜
石家庄市第三医院老年医学二科,河北石家庄 050000石家庄市第三医院老年医学二科,河北石家庄 050000石家庄市第三医院老年医学二科,河北石家庄 050000石家庄市第三医院老年医学二科,河北石家庄 050000石家庄市第三医院老年医学二科,河北石家庄 050000
医药卫生
老年慢性心力衰竭肺部感染N末端B型利钠肽原C反应蛋白胱抑素C心脏功能预后
elderly chronic heart failurepulmonary infectionN-terminal pro-B-type natriuretic peptideC-reactive pro-teincystatin Ccardiac functionprognosis
《四川医学》 2026 (5)
497-502,6
河北省医学科学研究课题计划项目(编号:20242374)
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