血清hs-CRP、cTnI、BNP及PCT联合检测对慢性心力衰竭的临床诊断价值

The clinical value on the combined detection of the serum hs-CRP,cTnI,BNP and PCT in chronic heart failure

目的探讨血清超敏C反应蛋白(hs-CRP)、心肌肌钙蛋白I(cTnI)、B型钠尿肽(BNP)和降钙素原(PCT)检测在慢性心力衰竭中的临床意义。方法选取2018年2月-2020年2月在辽宁省金秋医院诊治的135例慢性心力衰竭患者作为观察组,另选择同期100名健康体检者作为对照组。采集两组受试者空腹肘静脉血,采用化学发光法检测血清cTnI、BNP水平,采用免疫投射比浊法检测血清hs-CRP水平,采用免疫层析法检测血清PCT水平,超声心动图检测受试者左室舒张末期内径(LVEDD)和左室射血分数(LVEF)。Pearson相关系数分析观察组血清hs-CRP、cTnI、BNP和PCT与LVEDD、LVEF的相关性,分析血清hs-CRP、cTnI、BNP和PCT单独及联合检测对慢性心力衰竭的诊断价值。结果与对照组比较,观察组血清hs-CRP、cTnI、BNP和PCT水平均明显升高,差异有统计学意义(P<0.05);观察组不同心功能分级患者之间血清hs-CRP、cTnI、BNP和PCT水平差异有统计学意义(P<0.05)。观察组患者血清hs-CRP和cTnI、BNP、PCT水平均与LVEDD呈正相关(r=0.357、0.512、0.496、0.305,P均<0.05),与LVEF呈负相关(r=-0.317、-0.482、-0.426、-0.291,P均<0.05)。血清hs-CRP和cTnI、BNP、PCT联合检测对慢性心力衰竭的诊断准确度、敏感性和特异性均高于其单独检测。结论血清hs-CRP和cTnI、BNP、PCT水平与慢性心力衰竭患者心功能损伤有关,其联合检测可为慢性心力衰竭早期临床诊断提供参考依据,具有重要临床意义。

Objective To investigate the clinical significance of serum hypersensitive C-reactive protein(hs-CRP),cardiac troponin I(cTnI),brain natriuretic peptide(BNP)and procalcitonin(PCT)in chronic heart failure.Methods A total of 135 patients with chronic heart failure diagnosed and treated in our hospital from February 2018 to February 2020 were selected as the observation group,another 100 volunteers who underwent physical examination in our hospital during the same period were selected as the control group.Fasting elbow venous blood was collected from the two groups of subjects.Serum cTnI and BNP levels were detected by chemiluminescence;serum hs-CRP levels were detected by immunoturbidimetry;serum PCT levels were detected by immunochromatography,and left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were detected by echocardiography.Pearson correlation coefficient method was used to analyze the correlation between serum hs-CRP,cTnI,BNP and PCT with LVEDD and LVEF in the observation group,and to analyze the diagnostic value of serum hs-CRP,cTnI,BNP and PCT in the diagnosis of chronic heart failure.Results Compared with the control group,serum levels of hs-CRP,cTnI,BNP and PCT in the observation group were significantly increased(P<0.05).There were statistically significant differences in serum hs-CRP,cTnI,BNP and PCT levels between patients with different cardiac function grades in the observation group(P<0.05).The serum levels of hs-CRP,cTnI,BNP and PCT in the observation group were positively correlated with LVEDD(r=0.357,0.512,0.496,0.305,all P<0.05),and negatively correlated with LVEF(r=-0.317,-0.482,-0.426,-0.291,all P<0.05).The diagnostic accuracy,sensitivity and specificity of the combined detection of serum hs-CRP,cTnI,BNP and PCT for chronic heart failure were higher than that of the single detection.Conclusion Serum hs-CRP and cTnI,BNP,PCT levels were related to cardiac function damage in patients with chronic heart failure,and their joint detection could provide a reference for the early clinical diagnosis of chronic heart failure,and had important clinical significance.