心力衰竭合并肺部感染患者的细菌学特征及CHE、IL-6、PCT、NT-proBNP/BNP 比值水平变化及意义研究

Bacteriological characteristics and significance of CHE,IL-6,PCT,NT-proBNP/BNP ratio in patients with heart failure complicated with pulmonary infection

目的:探讨心力衰竭(HF)合并肺部感染患者的细菌学特征及胆碱酯酶(CHE)、白介素-6(IL-6)、降钙素原(PCT)、氨基末端B型利钠肽前体(NT-proBNP)/B型利钠肽(BNP)比值水平变化及临床意义。方法:选取2016年1月~2019年1月本院收治的127例心力衰竭患者为研究对象,根据是否合并肺部感染进行分组,分为感染组60例、未感染组67例,分析感染组患者病原菌分布特征,同时比较两组患者CHE、IL-6、PCT、NT-proBNP、BNP、NT-proBNP/BNP水平及与心功能的关系。结果:60例感染组患者共分离出病原菌81株,以革兰氏阴性菌为主。感染组患者的CHE水平均低于未感染组;IL-6、PCT、NT-proBNP、BNP、NT-proBNP/BNP均高于未感染组。感染组患者的左室射血分数(LVEF)低于未感染组、左室舒张末期容积指数(LVEFVI)和左室收缩末期容积指数(LVESDVI)高于未感染组。LVEF与CHE呈正相关,与IL-6、PCT、NT-proBNP/BNP呈负相关。LVEFVI与CHE呈负相关,与IL-6、PCT、NT-proBNP/BNP呈正相关。LVESDVI与CHE呈负相关,与IL-6、PCT、NT-proBNP/BNP呈正相关。结论:HF合并肺部感染以革兰氏阴性菌感染为主,患者CHE水平降低,IL-6、PCT及NT-proBNP/BNP比值均升高,且与心功能密切相关。

Objective To explore the bacteriological characteristics and significance of cholinesterase(CHE),interleukin-6(IL-6),procalcitonin(PCT),amino-terminal B-type natriuretic peptide precursor(NT-proBNP)/B type natriuretic peptide(BNP)ratio in patients with heart failure complicated with pulmonary infection.Methods 127 patients with heart failure between May 2016 and May 2019 were divided into the infected group(n=60)and the non-infection group(n=67).The distribution of pathogenic bacteria in the infected group was analyzed.The level of CHE of the infection group was lower than that of the non-infection group.The levels of IL-6,PCT,NT-proBNP,BNP,NT-proBNP/BNP and cardiac function were compared between the two groups.Results 81 strains of pathogenic bacteria were isolated from 60 patients in the infected group,mainly Gram-negative bacteria.The levels of CHE,IL-6,PCT,NT-proBNP,BNP,NT-proBNP/BNP of the infection groupd group was higher than that of the non-infection group.The level of left ventricular ejection fraction(LVEF)of the infected group was lower than that of the non-infection group,and the levels of left ventricular end-diastolic volume index(LVEFVI),left ventricular end-systolic volume index(LVESSDVI)of the infected group were higher than those of the control group.LVEF was positively correlated with CHE and negatively correlated with IL-6,PCT,NT-proBNP/BNP.LVEFVI was negatively correlated with CHE,positively correlated with IL-6,PCT,NT-proBNP/BNP.LVESDVI was negatively correlated with CHE and positively correlated with IL-6,PCT,NT-proBNP/BNP.Conclusion Gram-negative bacteria infection is the main infection in patients with heart failure complicated with pulmonary infection,and the level of CHE is lower and the levels of IL-6,PCT and NT-proBNP/BNP are high in patients with heart failure complicated with pulmonary infection,which is closely related to cardiac function.