老年慢性肺源性心脏病心力衰竭急性加重期患者血清降钙素原与B型利钠肽水平变化

发布时间：2018-11-07 11:59

【摘要】：目的探讨老年慢性肺源性心脏病心力衰竭急性加重期患者血清中降钙素原(PCT)和B型利钠肽(BNP)的水平及关系。方法选择66例老年慢性肺源性心脏病心力衰竭急性加重期患者,治疗前诱导痰细菌定量培养,测定其血清PCT及BNP水平;治疗后达缓解期时再次诱导痰细菌定量培养,并测定血清PCT及BNP水平。以痰中下呼吸道潜在病原菌(PPM)浓度≥107CFU/ml作为诊断慢性肺源性心脏病心力衰竭急性加重期细菌感染的标准,将急性加重期心力衰竭患者分为有细菌感染组(细菌组,22例)、无细菌感染组(非细菌组,44例),其中细菌、无细菌组中分别按照心功能分级Ⅰ级分为细菌1、无细菌1组,心功能Ⅱ、Ⅲ、Ⅳ级分为细菌2、无细菌2组两个亚组,并与40例健康体检者比较。结果 (1)66例患者在急性加重期时,31例(47%)痰培养出PPM,其中22例痰中PPM≥107CFU/ml。缓解期时13例患者的病原菌仍存留〔2.8×106(1.3×106~1.9×107)CFU/ml〕,但细菌浓度较急性加重期显著降低〔7.0×107(4.5×107~7.1×108)CFU/ml〕。(2)细菌组急性加重期PCT水平明显高于非细菌组,细菌2组PCT水平略高于细菌1组,细菌2组与非细菌2组急性发作期BNP水平均高于细菌1组与非细菌1组,细菌2组急性发作期BNP水平高于非细菌2组,细菌组与非细菌组加重期及稳定期BNP水平均高于正常对照组〔(21.34±3.22)pg/ml〕(P0.01)。结论慢性肺源性心脏病急性加重期患者血PCT水平升高与细菌感染有关,而BNP水平升高与患者心力衰竭严重程度有关,但不是唯一因素,细菌感染同样可致其升高。
[Abstract]:Objective to investigate the serum levels of procalcitonin (PCT) and type B natriuretic peptide (BNP) in elderly patients with acute exacerbation of chronic pulmonary heart disease (CHF). Methods 66 elderly patients with chronic pulmonary heart disease at acute exacerbation stage were selected and their serum PCT and BNP levels were measured by quantitative culture of induced sputum bacteria before treatment. After treatment, sputum bacteria were induced to be cultured quantitatively and serum PCT and BNP levels were measured. The patients with acute exacerbation of heart failure in chronic pulmonary heart disease were divided into two groups: bacterial infection group (bacterial group) with acute exacerbation of heart failure according to the (PPM) concentration 鈮，

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