PCT、NT⁃pro⁃BNP在心力衰竭并肺炎疾病程度、预后评估中的作用

The role of PCT and NT⁃pro⁃BNP in the evaluation of the disease degree and prognosis of heart failure complicated with pneumonia

目的研究降钙素原(PCT)、氨基酸B型钠尿肽前体(NT⁃pro⁃BNP)在心力衰竭并肺炎疾病程度、预后评估中的作用。方法选取2019年1月至2021年6月于山东大学齐鲁医院就诊的128例心力衰竭合并肺炎患者为研究组,同期98例体检正常者为对照组。比较不同人群PCT、NT⁃pro⁃BNP水平,分析PCT、NT⁃pro⁃BNP检测对心力衰竭并肺炎患者预后的预测价值。结果研究组PCT、NT⁃pro⁃BNP水平高于对照组,差异均有统计学意义(P<0.05)。不同疾病程度患者PCT、NT⁃pro⁃BNP水平比较为:高危组>中危组>低危组,差异均有统计学意义(P<0.05)。研究组在随访结束后死亡15例(11.72%),存活113例(88.28%)。死亡组PCT、NT⁃pro⁃BNP水平高于存活组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,联合PCT、NT⁃pro⁃BNP两者检测预测心力衰竭合并肺炎患者预后死亡的灵敏度和特异度分别为76.20%、71.40%,AUC=(95%CI:0.696~0.950),明显高于两者单独检测(P<0.05)。结论PCT、NT⁃pro⁃BNP在心力衰竭合并肺炎患者中表达均明显上调,通过检测上述因子水平可了解患者病情进展变化、评估预后情况。

Objective To study the role of procalcitonin(PCT)and Amino acid B⁃type natriuretic peptide precursor(NT⁃pro⁃BNP)in the evaluation of the disease degree and prognosis of heart failure complicated with pneumonia.Methods 128 patients with heart failure and pneumonia who were treated in Qilu Hospital of Shandong University from January 2019 to June 2021 were selected as the research group,98 patients with health examination during the same time period were set as the control group.The expression levels of PCT and NT⁃pro⁃BNP in different populations were compared,and the predictive value of PCT and NT⁃pro⁃BNP testing for the prognosis of patients with heart failure and pneumonia was analyzed.Results The levels of PCT and NT⁃pro⁃BNP in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The comparison of PCT and NT⁃pro⁃BNP levels in patients with different disease levels:high⁃risk group>medium⁃risk group>low⁃risk group,and the differences were statistically significant(P<0.05).In the study group,15 cases died(11.72%),113 cases survived(88.28%)after the follow⁃up.PCT and NT⁃pro⁃BNP levels in the death group were significantly higher than those in the survival group,and the differences were statistically significant(P<0.05).The ROC curve analysis results showed that the sensitivity and specificity of combined PCT and NT⁃pro⁃BNP detection to predict the prognosis of death in patients with heart failure and pneumonia were 76.20%and 71.40%,respectively,AUC=(95%CI:0.696~0.950),which were significantly higher than those of the two separate tests(P<0.05).Conclusion The expression of PCT andNT⁃pro⁃BNP are significantly up⁃regulated in patients with heart failure and pneumonia.By detecting the levels of the above factors,we can understand the progress of the patient's disease and evaluate the prognosis.