Abstract
Objective To investigate the clinical significance of N-terminal pro-BNP( NT-proBNP)for patients with community-acquired pneumonia( CAP)of different PCT levels. Methods We enrolled 287 CAP patients who received hospitalized treatment in Beijing Luhe Hospital Affiliated to Captial Medical University from January 2012 to December 2013. According to serum PCT level,the subjects were divided into four groups:group A(PCT<0. 10μg/L,n=110),group B(0. 10 μg/L≤PCT≤0. 25 μg/L,n=99),group C(0. 25 μg/L<PCT≤0. 50 μg/L,n=31)and group D(PCT>0. 50μg/L,n=47). The general clinical data and each laboratory examination indicator were analyzed and compared among the four groups,and the correlation between NT-proBNP and inflammatory markers,TNI and PSI was analyzed. Results (1) The four groups were significantly different(P<0. 05)in gender,average age and diabetes mellitus in complications and were not significantly different(P >0. 05)in chronic obstructive pulmonary disease,asthma,hypertension,coronary heart disease, atrial fibrillation and cerebrovascular diseases in complications. (2)The four groups were significantly different(P<0. 05)in temperature,heart rate,respiratory rate,PCT,NT-proBNP,PH,PO2,oxygenation index,WBC,NEUT,ESR,CRP, the score of PSI and were not significantly different(P>0. 05)in systolic pressure,diastolic pressure,TNI and PCO2. (3) Group A was significantly different(P<0. 05)in NT-proBNP from group C and group D,group B was significantly different (P<0. 05)in NT-proBNP from group C and group D,and group C was significantly different(P<0. 05)in NT-proBNP from group D. (4) The Spearman correlation analysis showed that NT-proBNP was positively correlated with TNI( rs =0. 21, P<0. 05),PCT(rs =0. 30,P<0. 05),WBC(rs =0. 15,P<0. 05),NEUT(rs =0. 25,P<0. 05),ESR(rs =0. 23, P<0. 05),CRP(rs =0. 40,P<0. 05)and PSI(rs =0. 54,P<0. 05). With PCT>0. 25 μg/L as the cutoff point,the Spearman correlation analysis was further conducted,and the results showed that NT-proBNP was positively correlated with PCT in patients with bacterial infection(rs =0. 40,P=0. 00). Conclusion The exacerbation of bacterial infection could lead to the increase of NT-proBNP level in patients, which may be mediated by bacterial endotoxin through inflammatory medium. NT-proBNP can be used as an indicator of disease severity degree and prognosis of CAP patients.关键词
社区获得性感染/肺炎,细菌性/氮末端脑钠肽前体/降钙素Key words
Community-acquired infections/Pneumonia,bacterial/N-terminal pro-BNP/Calcitonin分类
医药卫生
