| 李 峰,梁 强,舒远招,刘伟旺,滕明森.慢性心力衰竭合并肺部感染患者血清降钙素原、血管紧张素Ⅱ、人单核细胞趋化蛋白-1与心脏功能和预后不良的关系分析[J].,2022,(21):4195-4200 |
| 慢性心力衰竭合并肺部感染患者血清降钙素原、血管紧张素Ⅱ、人单核细胞趋化蛋白-1与心脏功能和预后不良的关系分析 |
| Analysis of the Relationship between Serum Procalcitonin, Angiotensin Ⅱ, Human Monocyte Chemoattractant Protein-1 and Cardiac Function and Poor Prognosis in Patients with Chronic Heart Failure Complicated with Pulmonary Infection |
| 投稿时间：2022-04-22 修订日期：2022-05-18 |
| DOI：10.13241/j.cnki.pmb.2022.21.036 |
| 中文关键词: 慢性心力衰竭 肺部感染 降钙素原 血管紧张素Ⅱ 单核细胞趋化蛋白-1 心脏功能 预后 |
| 英文关键词: Chronic heart failure Pulmonary infection Procalcitonin Angiotensin II Monocyte chemotactic protein-1 Cardiac function Prognosis |
| 基金项目:湖南省卫生健康委科研计划项目（20190480） |
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| 中文摘要: |
| 摘要 目的：探讨慢性心力衰竭（CHF）合并肺部感染患者血清降钙素原（PCT）、血管紧张素Ⅱ（Ang II）及人单核细胞趋化蛋白-1（MCP-1）与心脏功能和预后不良的关系。方法：选择2018年3月至2020年3月本院收治的CHF合并肺部感染患者94例作为合并感染组，同期收治的CHF未合并肺部感染患者54例作为对照组。采用化学发光免疫分析法检测血清PCT水平，采用酶联免疫吸附法检测血清Ang II、MCP-1水平，比较两组血清PCT、Ang II、MCP-1水平及心脏功能指标左室射血分数（LVEF）、左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）、心率（HR），分析合并感染组血清PCT、Ang II、MCP-1水平与LVEF、LVESD、LVEDD、HR的相关性。合并感染组患者积极治疗后根据住院期间和随访6个月是否发生不良心脏事件分为预后良好组和预后不良组，采用单因素及多因素logistic回归模型分析CHF合并肺部感染患者预后的影响因素。结果：合并感染组血清PCT、Ang II、MCP-1水平及LVESD、LVEDD、HR高于对照组（P＜0.05），LVEF低于对照组（P＜0.05）。血清PCT、Ang II、MCP-1水平与LVEF呈负相关（P＜0.05），与LVESD、LVEDD、HR呈正相关（P＜0.05）。单因素分析结果显示，CHF合并肺部感染患者的预后与心力衰竭病程、美国纽约心脏病协会（NYHA）心功能分级、N末端B型利钠肽原（NT-proBNP）、PCT、Ang II、MCP-1水平有关（P＜0.05）。多因素logistic回归分析显示，心力衰竭病程＞6年、NYHA心功能III级和IV级、NT-proBNP＞570 ng/L、PCT＞3.27 μg/L、Ang II＞68.47 ng/L及MCP-1＞267.65 ng/L是CHF合并肺部感染患者预后不良的危险因素（P＜0.05）。结论：CHF合并肺部感染患者血清PCT、Ang II、MCP-1水平异常升高，与患者心脏功能及预后不良有关，可作为患者心脏功能和预后评估的辅助指标。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum procalcitonin (PCT), angiotensin II (Ang II) and human monocyte chemotactic protein-1 (MCP-1) and cardiac function and poor prognosis in patients with chronic heart failure (CHF) complicated with pulmonary infection. Methods: 94 patients with CHF complicated with pulmonary infection who were treated in our hospital from March 2018 to March 2020 were selected as the combined infection group, in the same period, 54 patients with CHF without complicated with pulmonary infection who were treated as the control group. The level of serum PCT was detected by chemiluminescence immunoassay, the levels of serum Ang II and MCP-1 were detected by enzyme-linked immunosorbent assay. The levels of serum PCT, Ang II, MCP-1 and cardiac function indexes left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), heart rate (HR) were compared between the two groups. The correlation between the levels of serum PCT, Ang II, MCP-1 and LVEF, LVESD, LVEDD, HR was analyzed in the combined infection group. After active treatment, patients in the combined infection group were divided into good prognosis group and poor prognosis group according to whether adverse cardiac events occurred during hospitalization and follow-up for 6 months. Univariate and multivariate Logistic regression models were used to analyze the prognostic factors of patients with CHF complicated with pulmonary infection. Results: The levels of PCT, Ang II, MCP-1, LVESD, LVEDD and HR in the combined infection group were higher than those in the control group(P<0.05), and the level of LVEF was lower than that in the control group(P<0.05). The levels of serum PCT, Ang II and MCP-1 were negatively correlated with LVEF (P<0.05), and positively correlated with LVESD, LVEDD and HR (P<0.05). Univariate analysis showed that the prognosis of patients with CHF complicated with pulmonary infection was related to the course of heart failure, New York Heart Association (NYHA) cardiac function grade, N-terminal B-type natriuretic peptide (NT-proBNP), PCT, Ang II, MCP-1 levels (P<0.05). Multivariate Logistic regression analysis showed that the course of heart failure > 6 years, NYHA cardiac function grade III and IV, NT-proBNP > 570 ng/L, PCT>3.27 μg/L, Ang II>68.47 ng/L and MCP-1>267.65 ng/L were the risk factors for the prognosis of patients with CHF complicated with pulmonary infection (P<0.05). Conclusion: The abnormal increase of the levels of serum PCT, Ang II and MCP-1 in patients with CHF complicated with pulmonary infection is related to the cardiac function and prognosis of patients, and which can be used as an auxiliary index for the evaluation of cardiac function and prognosis of patients. |
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