老年急性呼吸衰竭患者血清hs-CRP、 GGT、CysC水平及其与心肌损伤的相关性

Serum hs-CRP,GGT and CysC levels and their correlation with myocardial injury in elderly patients with acute respiratory failure.

目的探究老年急性呼吸衰竭患者血清超敏C反应蛋白(hs-CRP)、γ-谷氨酰转移酶(GGT)、胱抑素C(CysC)水平及其与心肌损伤的相关性。方法回顾性收集2019年9月至2022年9月成都市第三人民医院收治的老年急性呼吸衰竭患者106例临床资料,按心肌损伤情况分为心肌损伤组37例和非心肌损伤组69例。比较两组患者的一般资料、血清hs-CRP、GGT、CysC水平,分析血清hs-CRP、GGT、CysC水平与心肌损伤的相关性,以及老年急性呼吸衰竭患者出现心肌损伤的危险因素。结果两组患者在年龄、性别、体重指数、原发疾病、合并糖尿病、合并高脂血症、呼吸衰竭类型、动脉血二氧化碳分压(PaCO_(2))等方面比较,差异均无统计学意义(P>0.05),心肌损伤组合并高血压病率高于非心肌损伤组,1秒用力呼气量/用力肺活量(FEV1/FVC)、动脉血氧分压(PaO_(2))均低于非心肌损伤组,差异均有统计学意义(P<0.05)。心肌损伤组血清N末端脑钠肽前体(NT-pro BNP)、肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)水平为(359.32±54.89)mg/L、(1.31±0.17)U/L、(28.46±2.86)mg/L,均高于非心肌损伤组[(271.44±45.35)mg/L、(0.08±0.01)U/L、(17.10±2.52)mg/L],血清hs-CRP、GGT、CysC水平为(53.97±9.80)mg/L、(29.49±5.08)U/L、(1.49±0.22)mg/L,均高于非心肌损伤组[(45.52±7.39)mg/L、(25.14±4.56)U/L、(1.31±0.18)mg/L],差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,血清hs-CRP、GGT、CysC水平与老年急性呼吸衰竭患者心肌损伤呈正相关(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,血清hs-CRP、GGT、CysC的曲线下面积分别为0.780、0.754和0.750,截断值分别为50.635 mg/L、25.415 U/L和1.515 mg/L;Logistics回归分析结果显示,合并高血压病、hs-CRP>50.635 mg/L、GGT>25.415 U/L、CysC>1.515 mg/L与老年急性呼吸衰竭患者心肌损伤相关(P<0.05)。结论血清hs-CRP、GGT、CysC水平与老年急性呼吸衰竭患者发生心肌损伤相关,可用于临床参考。

Objective To explore the levels of serum hypersensitive C-reactive protein(hs-CRP),γ-glutamyl transferase(GGT)and cystatin C(CysC)and their correlation with myocardial injury in elderly patients with acute respiratory failure.Methods The clinical data of 106 elderly patients with acute respiratory failure who were treated in Chengdu Third People's Hospital from September 2019 to September 2022 were retrospectively collected and the patients were divided into myocardial injury group(37 cases)and non-myocardial injury group(69 cases)according to myocardial injury status.The general information,levels of serum hs-CRP,GGT and CysC were compared.The correlation between serum hs-CRP,GGT and CysC levels and myocardial injury and the risk factors of myocardial injury in elderly patients with acute respiratory failure were analyzed.Results There were no significant differences in age,gender,body mass index,primary disease,diabetes mellitus,hyperlipidemia,respiratory failure type and arterial carbon dioxide partial pressure(PaCO_(2))between the two groups(P>0.05),the rate of hypertension in myocardial injury group was higher than that in non-myocardial injury grou,while the forced expiratory volume in 1 second(FEV1)/(forced vital capacity,FVC)and arterial partial pressure of oxygen(PaO_(2))were lower than those in non-myocardial injury group,the differences were statistically significant(P<0.05).The levels of serum N-terminal pro brain natriuretic peptide(NT-pro BNP),troponin I(cTnI)and creatine kinase MB(CK-MB)in myocardial injury group were(359.32±54.89)mg/L,(1.31±0.17)U/L,(28.46±2.86)mg/L,which were higher than those in non-myocardial injury group[(271.44±45.35)mg/L,(0.08±0.01)U/L,(17.10±2.52)mg/L],the levels of serum hs-CRP,GGT and CysC in myocardial injury group were(53.97±9.80)mg/L,(29.49±5.08)U/L,(1.49±0.22)mg/L,which were higher compared with those in non-myocardial injury group[(45.52±7.39)mg/L,(25.14±4.56)U/L,(1.31±0.18)mg/L],the differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum hs-CRP,GGT and CysC levels were positively correlated with myocardial injury in elderly patients with acute respiratory failure(P<0.05).Receiver operating characteristic(ROC)curve analysis results showed that the areas under the curves of serum hs-CRP,GGT and CysC were 0.780,0.754 and 0.750(P<0.05),and the cut-off values were 50.635 mg/L,25.415 U/L and 1.515 mg/L respectively.Logistics regression analysis revealed that hypertension,hs-CRP>50.635 mg/L,GGT>25.415 U/L and CysC>1.515 mg/L were correlated with myocardial injury in elderly patients with acute respiratory failure(P<0.05).Conclusion Serum hs-CRP,GGT and CysC levels are associated with myocardial injury in elderly patients with acute respiratory failure,and the above indicators can be used for clinical reference.