【摘要】：目的探討老年慢性肺源性心臟病心力衰竭急性加重期患者血清中降鈣素原(PCT)和B型利鈉肽(BNP)的水平及關(guān)系。方法選擇66例老年慢性肺源性心臟病心力衰竭急性加重期患者,治療前誘導(dǎo)痰細(xì)菌定量培養(yǎng),測(cè)定其血清PCT及BNP水平;治療后達(dá)緩解期時(shí)再次誘導(dǎo)痰細(xì)菌定量培養(yǎng),并測(cè)定血清PCT及BNP水平。以痰中下呼吸道潛在病原菌(PPM)濃度≥107CFU/ml作為診斷慢性肺源性心臟病心力衰竭急性加重期細(xì)菌感染的標(biāo)準(zhǔn),將急性加重期心力衰竭患者分為有細(xì)菌感染組(細(xì)菌組,22例)、無細(xì)菌感染組(非細(xì)菌組,44例),其中細(xì)菌、無細(xì)菌組中分別按照心功能分級(jí)Ⅰ級(jí)分為細(xì)菌1、無細(xì)菌1組,心功能Ⅱ、Ⅲ、Ⅳ級(jí)分為細(xì)菌2、無細(xì)菌2組兩個(gè)亞組,并與40例健康體檢者比較。結(jié)果 (1)66例患者在急性加重期時(shí),31例(47%)痰培養(yǎng)出PPM,其中22例痰中PPM≥107CFU/ml。緩解期時(shí)13例患者的病原菌仍存留〔2.8×106(1.3×106~1.9×107)CFU/ml〕,但細(xì)菌濃度較急性加重期顯著降低〔7.0×107(4.5×107~7.1×108)CFU/ml〕。(2)細(xì)菌組急性加重期PCT水平明顯高于非細(xì)菌組,細(xì)菌2組PCT水平略高于細(xì)菌1組,細(xì)菌2組與非細(xì)菌2組急性發(fā)作期BNP水平均高于細(xì)菌1組與非細(xì)菌1組,細(xì)菌2組急性發(fā)作期BNP水平高于非細(xì)菌2組,細(xì)菌組與非細(xì)菌組加重期及穩(wěn)定期BNP水平均高于正常對(duì)照組〔(21.34±3.22)pg/ml〕(P0.01)。結(jié)論慢性肺源性心臟病急性加重期患者血PCT水平升高與細(xì)菌感染有關(guān),而BNP水平升高與患者心力衰竭嚴(yán)重程度有關(guān),但不是唯一因素,細(xì)菌感染同樣可致其升高。
[Abstract]:Objective to investigate the serum levels of procalcitonin (PCT) and type B natriuretic peptide (BNP) in elderly patients with acute exacerbation of chronic pulmonary heart disease (CHF). Methods 66 elderly patients with chronic pulmonary heart disease at acute exacerbation stage were selected and their serum PCT and BNP levels were measured by quantitative culture of induced sputum bacteria before treatment. After treatment, sputum bacteria were induced to be cultured quantitatively and serum PCT and BNP levels were measured. The patients with acute exacerbation of heart failure in chronic pulmonary heart disease were divided into two groups: bacterial infection group (bacterial group) with acute exacerbation of heart failure according to the (PPM) concentration 鈮，

本文編號(hào)：2316299