血清PCT联合hs-CRP检测对心力衰竭并发肺部感染患者的早期诊断预测及预后价值

目的探讨血清降钙素原(PCT)联合超敏C反应蛋白(hs-CRP)无创检测对心力衰竭并发肺部感染患者的预测价值。方法选择2019年1月至2021年12月在本院就诊的心力衰竭患者178例,其中78例合并肺部感染设为感染组,100例未合并感染设为非感染组。此外,选取同期在本院体检的50名健康人作为对照组。比较三组患者的入院时血清PCT、hs-CRP、白细胞(WBC)、中性粒细胞数(N)水平,并探讨PCT、hs-CRP对心力衰竭合并肺部感染患者的诊断价值。结果感染组患者的血清PCT、hs-CRP、WBC、N水平高于非感染组及对照组(P<0.05)。感染组患者的左室收缩末期容积指数(LVESVI)、左室舒张末期容积指数(LVEDVI)较非感染组高,左室射血分数(LVEF)水平较非感染组低(P<0.05)。PCT联合hs-CRP诊断心力衰竭合并肺部感染的曲线下面积(AUC)、敏感性和特异性分别为0.852、0.8和0.787,与单纯hs-CRP或PCT相比,差异均有统计学意义(P<0.05)。PCT联合hs-CRP预测心力衰竭合并肺部感染患者预后的AUC、敏感性和特异性分别为0.814、0.87和0.694,与单指标hs-CRP或PCT相比,差异均有统计学意义(P<0.05)。结论相对肺部有创确诊感染,微创获得PCT联合hs-CRP指标在心力衰竭疑似肺部感染的早期诊断中具有一定的临床科学价值。此外,这两个指标的综合分析是评估该疾病预后的重要指标之一。

Objective This study aimed to explore the predictive value of non-invasive detection of serum procalcitonin(PCT)combined with high-sensitivity C-reactive protein(hs-CRP)for patients with heart failure complicated by pulmonary infection.Methods 178 patients with heart failure who visited our hospital from January 2019 to December 2021,including 78 cases with pulmonary infection(infection group)and 100 cases without infection(non-infection group)were selected.Additionally,50 healthy individuals examined at our hospital during the same period were selected as the control group.The serum PCT,hs-CRP,white blood cell(WBC),and neutrophil(N)levels at admission of the three groups were compared,and the diagnostic value of PCT and hs-CRP for patients with heart failure complicated by pulmonary infection was explored.Results The serum PCT,hs-CRP,WBC,and N levels in the infection group were higher than those in the non-infection group and the control group(P<0.05).The left ventricular end-systolic volume index(LVESVI)and left ventricular end-diastolic volume index(LVEDVI)in the infection group were higher than those in the non-infection group,while the left ventricular ejection fraction(LVEF)was lower(P<0.05).The area under the curve(AUC),sensitivity,and specificity of PCT combined with hs-CRP for the diagnosis of heart failure complicated by pulmonary infection were 0.852,0.8,and 0.787,respectively,and the differences were statistically significant compared to hs-CRP or PCT alone(P<0.05).The AUC,sensitivity,and specificity of PCT combined with hs-CRP for predicting the prognosis of patients with heart failure complicated by pulmonary infection were 0.814,0.87,and 0.694,respectively,and the differences were statistically significant compared to single indicator hs-CRP or PCT(P<0.05).Conclusion The minimally invasive acquisition of PCT combined with hs-CRP indicators has certain clinical scientific value in the early diagnosis of suspected pulmonary infection in patients with heart failure compared to invasive pulmonary infection diagnosis.Moreover,the comprehensive analysis of these two indicators is one of the important indices for evaluating the prognosis of this disease.