Cys-c、SAA及CRP水平与慢性心力衰竭并发肺部感染的关系

The relationship between Cys-c,SAA and CRP levels and chronic heart failure complicated with pulmonary infection

目的 分析半胱氨酸蛋白酶抑制剂C(Cys-c)、淀粉样蛋白A(SAA)及C-反应蛋白(CRP)与慢性心力衰竭并发肺部感染的关系。方法 选取2018年2月至2020年8月首都医科大学附属北京世纪坛医院接收的90例慢性心力衰竭患者(研究组),根据是否肺部感染分为合并感染组(n=36),未合并感染组(n=54);另选取98名同期行健康体检者(对照组)。比较各组Cys-c、SAA及CRP水平,分析慢性心力衰竭并肺部感染的危险因素及Cys-c、SAA及CRP对慢性心力衰竭肺部感染的预测价值。结果 研究组Cys-c、SAA及CRP水平高于对照组,差异有统计学意义(P<0.05)。合并感染组Cys-c、SAA及CRP水平高于未合并感染组,差异有统计学意义(P<0.05)。有吸烟史、进行侵入性操作、Cys-c、SAA及CRP水平异常升高为CHF并发肺部感染的危险因素(P<0.05)。联合Cys-c、SAA及CRP检测敏感度、特异度、约登指数、AUC为0.975、0.813、0.788、0.961,均高于单一指标检测(P<0.05)。结论 Cys-c、SAA及CRP水平在慢性心力衰竭患者中显著升高,且均为CHF并发肺部感染的危险因素,联合三者检测对评估患者病情有重要价值。

Objective To analyze the relationship between cysteine protease inhibitor C(Cys-c),serum amyloid A protein(SAA)and C-reactive protein(CRP)and chronic heart failure complicated with pulmonary infection. Methods 90 patients with chronic heart failure admitted to Beijing Shijitan Hospital Affiliated to Capital Medical University from February 2018 to August 2020 were selected(study group),and according to whether they had lung infection,they were divided into the combined infection group(n=36),the non-combined infection group(n=54). In addition,98 patients who had physical examination during the same period were selected(control group). The levels of Cys-c,SAA and CRP in each group were compared,and the risk factors of chronic heart failure complicated with pulmonary infection and the predictive value of Cys-c,SAA and CRP on pulmonary infection in chronic heart failure were analyzed. Results The levels of serum Cys-c,SAA and CRP in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05). The levels of Cys-c,SAA and CRP in the combined infection group were higher than those in the non-combined infection group,and the difference was statistically significant(P<0.05). Smoking history,invasive operation,abnormally elevated levels of Cys-c,SAA and CRP were risk factors affecting CHF complicated with lung infection(P<0.05). The sensitivity,specificity,Youden index,and AUC of combined Cys-c,SAA and CRP detection were 0.975,0.813,0.788,0.961,which were higher than those of single detection(P<0.05). Conclusion The levels of serum Cys-c,SAA and CRP were significantly increased in patients with chronic heart failure,and they were all risk factors for CHF complicated by pulmonary infection. Combined detection of the three is of great value in evaluating the patient’s condition.