重症肺炎患者血浆肌钙蛋白I、脑钠肽水平及心肌损伤的影响因素

Plasma Cardiac Troponin I and Brain Natriuretic Peptide Levels and Influencing Factors of Myocardial Injury in Patients with Severe Pneumonia

目的探究重症肺炎患者血浆肌钙蛋白I(cTnI)、脑钠肽(BNP)水平及心肌损伤的影响因素。方法选取2019年7月至2021年7月郑州大学附属郑州中心医院收治的108例重症肺炎患者,将其纳入研究组,按是否发生心肌损伤将患者分为损伤组(n=34)和非损伤组(n=74)。另选同期收治的48例普通肺炎患者纳入普通组,同期体检的48例健康人群纳入对照组。比较3组患者血浆cTnI、BNP水平,并分析影响心肌损伤的相关因素。结果3组患者血浆cTnI、BNP水平比较,从高至低依次为研究组、普通组、对照组(P<0.05)。单因素方差分析结果显示,损伤组、非损伤组患者性别、年龄、体质量指数(BMI)、病程、早产、黄疸、贫血、肺炎感染类型比较,差异无统计学意义(P>0.05),损伤组患者cTnI、BNP、白细胞(WBC)计数水平均高于非损伤组(P<0.05)。logistic回归分析结果显示,高cTnI、BNP是影响心肌损伤的独立危险因素。结论重症肺炎患儿cTnI、BNP水平异常升高,是影响心肌损伤的独立危险因素。早期需重视对重症肺炎患者cTnI、BNP相关指标的监测,为心肌损伤的发生发展起积极预防作用。

Objective To explore the levels of cardiac troponin I(cTnI)and brain natriuretic peptide(BNP)and the influencing factors of myocardial injury in patients with severe pneumonia.Methods From July 2019 to July 2021,108 patients with severe pneumonia admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University were included in the study group,and they were divided into injury group(n=34)and non-injury group(n=74)according to whether myocardial injury occurred.In addition,48 patients with common pneumonia admitted in the same time were included in the general group,and 48 healthy people who received physical examination during the same period were included in the control group.The plasma cTnI and BNP levels of the three groups were compared,and the related factors affecting myocardial injury were analyzed.Results The cTnI and BNP levels of the three groups were compared from high to low in the order of study group,normal group and control group(P<0.05).The results of one-way ANOVA showed that there was no statistically significant difference in gender,age,BMI,course of disease,premature delivery,jaundice,anemia and pneumonia infection types between the injury group and the non-injury group(P>0.05).The cTnI,BNP and white blood cell(WBC)counts in the injury group were higher than those in the non-injury group(P<0.05).Logistic regression analysis showed that high cTnI and BNP were independent risk factors affecting myocardial injury.Conclusion The levels of cTnI and BNP in children with severe pneumonia are abnormally elevated,and they are independent risk factors affecting myocardial injury.In the early stage,attention should be paid to the monitoring of cTnI and BNP related indicators in patients with severe pneumonia,so as to actively prevent the occurrence and development of myocardial injury.