重症肺炎患者血清降钙素原、脂肪酶、D-二聚体及氨基末端脑钠肽水平与心肌损害程度的关系

The relationship between the levels of serum PCT,LPS,D-D and NT-BNP and the degree of myocardial damage in patients with severe pneumonia

目的探讨重症肺炎患者血清降钙素原(PCT)、脂肪酶(LPS)、D-二聚体(D-D)及氨基末端脑钠肽(NT-BNP)水平与心肌损害程度的关系。方法2017年4月至2020年12月我院收治的96例重症肺炎患者,其中合并心肌损害者62例(心肌损害组),未合并心肌损害者34例(非心肌损害组),同期我院健康体检者50例(健康对照组)。检测并比较三组血清心肌损害指标乳酸脱氢酶(LDH)、肌酸激酶MB同工酶(CK-MB)、肌酸激酶(CK)、肌钙蛋白T(cTnT)及PCT、LPS、D-D、NT-BNP水平;分析重症肺炎患者合并心肌损害的危险因素;分析血清PCT、LPS、D-D、NT-BNP水平与心肌损害指标的相关性。结果心肌损害组、非心肌损害组、健康对照组血清LDH、CK-MB、CK、cTnT及PCT、LPS、D-D、NT-BNP水平均依次降低,差异有统计学意义(P<0.05);血清PCT、LPS、D-D、NT-BNP是重症肺炎患者心肌损害的独立危险因素(P<0.05);重症肺炎患者血清PCT、LPS、D-D、NT-BNP水平与LDH、CK-MB、CK、cTnT均呈正相关(P<0.05)。结论重症肺炎患者血清PCT、LPS、D-D、NT-BNP水平与心肌损害程度密切相关,可作为患者心肌损伤的可靠预测指标。

Objective To investigate the relationship between the levels of serum procalcitonin(PCT),lipase(LPS),D-dimer(D-D)and amino-terminal brain natriuretic peptide(NT-BNP)and the degree of myocardial damage in patients with severe pneumonia.Methods From April 2017 to December 2020,96 patients with severe pneumonia were treated in our hospital,including 62 patients with myocardial damage(myocardial damage group)and 34 patients without myocardial damage(non-myocardial damage group).At the same time,50 healthy subjects in our hospital were selected as a healthy control group.The levels of serum myocardial damage indexes such as lactate dehydrogenase(LDH),creatine kinase MB isoenzyme(CK-MB),creatine kinase(CK),and troponin T(cTnT)as well as the levels of serum PCT,LPS,D-D and NT-BNP were detected and compared.The risk factors of severe pneumonia complicated with myocardial damage were analyzedamongthe three groups.The correlation between the levels of serum PCT,LPS,D-D and NT-BNP and the myocardial damage indexes was analyzed.Results The levels of serum LDH,CK-MB,CK,cTnT,PCT,LPS,D-D,and NT BNP in the myocardial damage group,the non-myocardial damage group,and the healthy control group were decreased in turn(P<0.05).Serum PCT,LPS,D-D and NT-BNP were independent risk factors for myocardial damage in patients with severe pneumonia(P<0.05).The levels of serum PCT,LPS,D-D and NT BNP in patients with severe pneumonia were positively correlated with LDH,CK-MB,CK and cTnT(P<0.05).Conclusion The levels of serum PCT,LPS,D-D and NT-BNP in patients with severe pneumonia are closely related to the degree of myocardial damage.These indexes can be used as reliable predictors of myocardial damage.