急性心肌梗死合并心力衰竭患者血清PCT、BNP水平变化及其与心功能的相关性

Detection of serum procalcitonin and B-type natriuretic peptide levels and their correlation with cardiac function in patients with acute myocardial infarction complicated with heart failure

目的 检测急性心肌梗死(AMI)合并心力衰竭(HF)患者血清降钙素原(PCT)、B型尿钠肽(BNP)水平,并探讨其与心功能的相关性。方法 回顾性分析2018年3月至2020年3月肇庆市第一人民医院急诊科收治的100例AMI合并HF患者的临床资料(观察组),其中美国纽约心脏病协会(NYHA)心功能分级Ⅱ级35例,Ⅲ级48例,Ⅳ级17例,并选择同期我院收治的90例单纯性AMI患者作为对照组。比较观察组和对照组以及观察组中不同心功能分级患者的血清PCT、BNP水平,并比较观察组和对照组患者的左室舒张末期内径(LVEDD)、左房舒张末期前后径(LAED)、左室射血分数(LVEF)。采用Pearson相关性分析法分析血清PCT、BNP水平与LVEDD、LAED、LVEF的相关性。结果 观察组患者的血清PCT、BNP水平分别为(13.01±2.28)μg/L、(470.33±20.51) ng/L,明显高于对照组的(6.12±1.43)μg/L、(127.50±11.02) ng/L,差异均有统计学意义(P<0.05);观察组患者随着心功能分级的增加,血清PCT、BNP水平逐渐升高,差异均有统计学意义(P<0.05);观察组患者的LVEDD、LAED分别为(67.48±8.80) mm、(60.10±7.19) mm,明显长于对照组的(60.69±5.37) mm、(52.01±4.50) mm,LVEF为(34.20±3.48)%,明显低于对照组的(40.00±6.62)%,差异均具有统计学意义(P<0.05);经Pearson相关分析结果显示,血清PCT、BNP水平与LVEDD、LAED均呈正相关(r=0.440、0.604、0.563、0.792,P<0.05),与LVEF均呈负相关(r=-0.415、0.430,P<0.05)。结论 AMI合并HF血清PCT、BNP水平与心功能密切相关,对其检测可评估患者心功能情况。

Objective To detect the serum procalcitonin(PCT) and B-type natriuretic peptide(BNP) levels in patients with acute myocardial infarction(AMI) complicated with heart failure(HF), and explore its correlation with cardiac function. Methods The clinical data of 100 patients with AMI complicated with HF admitted to Department of Emergency, Zhaoqing First People’s Hospital from March 2018 to March 2020 were retrospectively analyzed(the observation group), including 35 cases of grade Ⅱ, 48 cases of grade Ⅲ, and 17 cases of grade Ⅳ according to cardiac function grading of New York Heart Association(NYHA). Ninety patients with simple AMI admitted to the hospital during the same period were selected as the control group. The serum PCT and BNP levels were compared between the observation group and the control group, and also among patients with different cardiac functions in the observation group. The left ventricular end diastolic diameter(LVEDD), left atrial end diastolic diameter(LAED), and left ventricular ejection fraction(LVEF) were compared between the observation group and the control group. Pearson correlation analysis was used to analyze the correlation between serum PCT, BNP levels and LVEDd, LAED, LVEF. Results The serum PCT and BNP levels of the observation group were(13.01±2.28) μg/L and(470.33±20.51) ng/L, which were significantly higher than(6.12±1.43) μg/L and(127.50±11.02) ng/L in the control group(P<0.05). In the observation group, with the increase of cardiac function grade, the serum PCT and BNP levels gradually increased, and the differences were statistically significant(P<0.05). LVEDD and LAED in the observation group were(67.48±8.80) mm and(60.10±7.19) mm,which were significantly longer than(60.69 ± 5.37) mm and(52.01 ± 4.50) mm of the control group, and LVEF was(34.20±3.48)%, which was significantly lower than(40.00±6.62)% of the control group, with statistically significant differences(P<0.05). Pearson correlation analysis showed that serum PCT and BNP levels were positively correlated with LVEDD and LAED(r=0.440, 0.604, 0.563, 0.792, P<0.05), and negatively correlated with LVEF levels(r=-0.415,0.430, P<0.05). Conclusion The levels of serum PCT and BNP in patients with AMI complicated with HF are closely related to heart function, which can be used to evaluate the cardiac function of patients.