慢性心力衰竭并发感染患者病原学及脑钠肽变化研究

Study on the etiology in patients with chronic heart failure complicated with infection and changes in brain natrium peptide

目的探讨美国纽约心脏病学会(NYHA)Ⅰ~Ⅳ级慢性心力衰竭并发感染患者感染部位、菌种及脑钠肽(BNP)水平的变化。方法选取102例慢性心力衰竭并发感染患者作为感染组,研究其感染部位及菌种;另选取同期收治入院的102例单纯慢性心力衰竭患者为未感染组。比较2组BNP含量差异;比较未感染组入院治疗过程中发生感染前后BNP含量,以及分析感染前后BNP增量趋势。结果感染组体温、超敏C反应蛋白、白细胞介素-6、降钙素原、BNP含量高于未感染组,差异有统计学意义(P<0.05)。感染组主要感染部位为下呼吸道,主要致病菌为铜绿假单胞菌。未感染组出现感染后的BNP高于感染前,差异有统计学意义(P<0.05),感染前后不同NYHA分级BNP增量呈递增趋势。结论慢性心力衰竭患者感染部位主要在下呼吸道,以铜绿假单胞菌感染多见,感染可致心力衰竭患者BNP含量升高。临床在应用BNP辅助诊疗、评估心力衰竭预后时,应充分考虑感染对BNP的影响。

Objective To investigate the sites of infection,bacterial species and the levels of brain natreuretic peptide(BNP)in chronic heart failure complicated with infection patients with New York Heart Association(NYHA)gradeⅠtoⅣ.Methods One hundred and two patients with chronic heart failure complicated with infection were selected as infection group,and the infection sites and bacterial species were studied.Another 102 patients with simple chronic heart failure admitted to hospital during the same period were selected as uninfection group.The difference of BNP content between the two groups was compared.The levels of BNP before and after infection were compared in the uninfection group during hospitalization,and BNP increment trend before and after infection was analyzed.Results The body temperature,hypersensitivity C-reactive protein,interleukin-6,procalcitonin and BNP in the infection group were significantly higher than those in the uninfection group(P<0.05).In the infection group,the main infection site was lower respiratory tract,and the main pathogenic bacteria was Pseudomonas aeruginosa;the BNP level after infection was significantly higher than that before infection in the uninfection group(P<0.05).After infection,the BNP of different NYHA classification showed an increasing trend.Conclusion The infection site of patients with chronic heart failure is mainly in the lower respiratory tract,and Pseudomonas aeruginosa infection is most common.Infection can increase the BNP content in patients with heart failure.The influence of infection on BNP should be fully considered to evaluate the prognosis of heart failure when using BNP to assist diagnosis and treatment.