|
|
|
| Relationship between Levels of Serum Cholinesterase NT-pro BNP and PCT and Prognosis in Patients with Heart Failure and Pulmonary Infection |
| CHEN Gonghai, YAN Guanghuan, WANG Guangquan |
| Qionghai People's Hospital, Hainan Qionghai 571400, China |
|
|
|
|
Abstract Objective: To explore the clinical value of serum cholinesterase (CHE), N-terminal pro-brain natriuretic peptide (NT-proBNP) and procalcitonin (PCT) on diagnosis and prognosis assessment of patients with heart failure and pulmonary infection. Methods: The clinical data of 120 patients with heart failure and pulmonary infection were retrospectively analyzed. According to the New York Heart Association (NYHA) cardiac function grading and 28d survival, they were divided into grade II group (n=42), grade III group (n= 49) and grade IV group (n=29) and death group (n=23) and survival group (n=97), and the clinical data of 162 patients with simple heart failure were included in controls. The levels of serum CHE, NT-proBNP and PCT were compared among patients with different disease condition and prognosis. The correlation between the above indexes and cardiac function was analyzed by Spearman correlation coefficient model. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of the above indexes in predicting 28d survival of patients with heart failure and pulmonary infection. Results: Serum CHE level in patients with heart failure and pulmonary infection was significantly lower than that of patients without pulmonary infection while the levels of serum NT-proBNP and PCT were significantly higher than those of patients without pulmonary infection (P<0.05). Among patients with heart failure and pulmonary infection with different cardiac function, serum CHE level showed grade II group> grade III group> grade IV group, and the levels of serum NT-proBNP and PCT showed grade II group< grade III group< grade IV group (P<0.05). Serum CHE level was significantly negatively correlated with cardiac function in patients with heart failure and pulmonary infection (r<0, P<0.05) while levels of serum NT-proBNP and PCT were significantly positively correlated with cardiac function (r>0, P<0.05). Serum CHE level in death group was significantly lower than that in survival group while levels of serum NT-proBNP and PCT were significantly higher than those in survival group (P<0.05). The AUC values of ROC curves of CHE, NT-proBNP and PCT in predicting 28d death of patients with heart failure and pulmonary infection were significantly smaller than those of combination prediction (P<0.05), and the cut-off values were 4.18 kU/L, 11.61 μg/L and 10.04 μg/L respectively. Conclusion: Serum CHE, NT-proBNP and PCT levels are closely related to the prognosis of patients with heart failure and pulmonary infection. Early clinical combination testing can help guide the diagnosis and treatment plan, so as to take appropriate intervention measures to improve the prognosis as soon as possible.
|
|
|
|
|
|
[1] Dharmarajan K, Rich MW. Epidemiology pathophysiology and prognosis of heart failure in older adults[J]. Heart Fail Clin, 2017, 13(3):417~426.
[2] Bylova NA, Arutyunov GP, Rylova AK, et al. Prognostic role of body composition in patients with pneumonia associated with decompensated CHF[J]. Kardiologiia, 2017, 57(S2):343~350.
[3] 温红静,卢雄豪,余光勇,等.缺血性心力衰竭患者尿NGAL水平与血清pro-BNP相关性及诊断价值分析[J].河北医学,2019,25(5):711~716.
[4] 赵江南,施毅.定量检测血清降钙素原对肺部感染患者的诊治意义[J].中华内科杂志,2018,57(10):761~762.
[5] 谢正平,李代欣.儿童麻疹肺部感染的影像学表现与PCT相关性[J].临床放射学杂志,2017,36(10):1488~1493.
[6] Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Geart Association task force on clinical practice guidelines and the heart failure society of america[J].Card Fail, 2017, 23(8):628~651.
[7] Wunderink RG, Waterer G. Advances in the causes and management of community acquired pneumonia in adults[J]. BMJ, 2017, 358(7):j2471. |
|
|
|
2019, Vol. 25 
