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

目的探讨B型利钠肽(BNP)、氨基末端B型利钠肽前体(NT-proBNP)、降钙素原(PCT)、NT-proBNP/BNP比值在老年心力衰竭合并肺部感染患者中水平变化及意义,为临床评估心力衰竭患者病情严重程度提供参考。方法2012年12月至2015年12月我院收治的276例心力衰竭患者,依据是否发生肺部感染分为感染组(130例)和非感染组(146例),分析两组患者PCT、NT-proBNP、BNP、NT-proBNP/BNP比值差异,各指标与心功能的关系。结果 PCT、NTproBNP/BNP比值、NT-proBNP感染组明显高于非感染组(P<0.05),BNP水平两组比较无明显差异(P>0.05);肺部感染患者PCT、BNP、NT-proBNP水平随着心功能分级增加而升高(P<0.05),NT-proBNP/BNP比值在不同心功能分级患者之间无显著性差异(P>0.05);感染组患者NT-proBNP/BNP比值与PCT呈正相关(r=0.621,P<0.05),BNP、NT-proBNP与PCT均无显著相关性(P>0.05)。结论 NT-proBNP/BNP比值在老年心力衰竭合并肺部感染患者中由于不受心功能影响,可反映患者感染严重程度。

Changes and Significance of BNP,NT-proBNP,PCT,NT-proBNP/BNP Ratio in Elderly Patients with Heart Failure Complicated with Pulmonary Infection

Objective To investigate the changes and significance of B type natriuretic peptide( BNP),amino terminal B type natriuretic peptide( NT-proBNP),procalcitonin( PCT),the ratio of NT-proBNP/BNPin elderly patients with heart failure complicated with pulmonary infection,to provide a reference for the clinical evaluation of the severity of heart failure patients.Methods 276 cases of patients with heart failure admitted to the hospital from December 2012 to December 2015 were divided into infection group( 130 cases) and non infection group( 146 cases),according to the occurrence of pulmonary infection. The differences of the ratio of PCT,NT-proBNP,BNP,NT-proBNP/BNP and the relationship between the indexes and cardiac function were analyzed in the two groups. Results The PCT,NT-proBNP/BNP ratio and NT-proBNP in the infection group were significantly higher than those in the non infection group( P<0. 05),but there was no significant difference between the two groups in the level of BNP( P>0. 05); The levels of PCT,BNP and NT-proBNP in patients with pulmonary infection increased with the increase of cardiac function( P<0. 05),and there was no significant difference in NT-proBNP/BNP ratio between patients with different functional grades( P > 0. 05); The ratio of NT-proBNP/to BNP in the infection group was positively correlated with PCT( r= 0. 621,P<0. 05),and there was no significant correlation between BNP,NT-proBNP and PCT( P>0. 05). Conclusion Ratio of NT-proBNP/BNP can reflect the severity of infection in elderly heart failurepatients complicated with pulmonary infection because it is not affected by cardiac function.