血清BNP、PCT、IL-6水平对老年心力衰竭患者并发肺部感染预测价值分析

Predictive value of serum BNP,PCT and IL-6 levels in elderly patients with heart failure complicated with pulmonary infection

目的探讨血清脑钠肽(BNP)、降钙素原(PCT)及白介素-6(IL-6)检测对老年心力衰竭(HF)患者并发肺部感染的预测价值。方法选取2020年7月~2022年6月界首市人民医院收治的102例老年HF患者,根据是否并发肺部感染将其分为感染组(42例)和未感染组(60例),比较两组患者的血清生化指标,采用logistic回归分析并绘制受试者工作特征(ROC)曲线分析其预测效能。结果102例老年HF患者中,并发肺部感染率为41.18%;因素分析结果显示,糖尿病、肺间质阴影、渗出性病变、发热、黄痰、吸烟史、白细胞(WBC)、血清BNP、PCT和IL-6均为老年HF患者并发肺部感染的主要因素,其中吸烟史、肺间质阴影、渗出性病变、发热、黄痰、血清BNP、PCT和IL-6是其独立危险因素(P<0.05,OR>1);ROC曲线分析显示,血清BNP、PCT和IL-6的曲线下面积为0.885、0.652、0.772和0.959,灵敏度为95.20%、95.20%、90.50%和97.60%,特异度为93.30%、70.00%、86.70%和98.30%,各项指标水平最佳阈值为:PCT=2.2 ng/L;BNP=639.10 pg/ml;IL-6=91.86μmol/L。结论血清BNP、PCT和IL-6等水平与老年HF患者并发肺部感染密切相关,可作为指标因子联合预测患者发生肺部感染。

Objective To investigate the predictive value of serum natriuretic peptide(BNP),procalcitonin(PCT)and interleukin-6(IL-6)in elderly patients with heart failure(HF)complicated with pulmonary infection.Methods A total of 102 elderly patients with HF admitted to Jieshou People's Hospital from July 2020 to June 2022 were selected and divided into infection group(n=42)and non-infection group(n=60)according to whether they were complicated with pulmonary infection.The serum biochemical indexes of the two groups were compared.Logistic regression analysis and ROC curve were used to analyze the predictive efficacy.Results Among 102 elderly patients with HF,the incidence of pulmonary infection was 41.18%.The results of factor analysis showed that diabetes,interstitial shadow,exudative lesions,fever,yellow sputum,smoking history,white blood cell(WBC),serum BNP,PCT and IL-6 were the main factors of pulmonary infection in elderly HF patients,among which smoking history,interstitial shadow,exudative lesions,fever,yellow sputum,serum BNP,PCT and IL-6 were independent risk factors(P<0.05,OR>1).ROC curve analysis showed that the area under the curve of serum BNP,PCT and IL-6 was 0.885,0.652,0.772 and 0.959,the sensitivity was 95.20%,95.20%,90.50%and 97.60%,and the specificity was 93.30%,70.00%,86.70%and 98.30%.The optimal threshold of each index level was:PCT=2.2 ng/L;BNP=639.10 pg/ml;IL-6=91.86μmol/L.Conclusions Serum BNP,PCT and IL-6 levels are closely related to pulmonary infection in elderly patients with HF,which can be used as an indicator factor to predict pulmonary infection.