检验医学与临床2025，Vol.22Issue(22)：3079-3083,3089,6.DOI:10.3969/j.issn.1672-9455.2025.22.010
老年慢性心力衰竭合并肺部感染患者病原学分布及FIB、ACTH、ANGPTL4检测的临床意义
Etiologic distribution in elderly patients with chronic heart failure complicating pulmonary infection and clinical significance of FIB,ACTH and ANGPTL4 testing
摘要
Abstract
Objective To analyze the distribution characteristics of pathogenic microorganisms in elderly patients with chronic heart failure(CHF)complicating pulmonary infection,and to explore the significance of plasma fibrinogen(FIB),serum adrenocorticotropic hormone(ACTH)and angiopoietin-like protein 4(AN-GPTL4)in elderly patients with CHF complicating pulmonary infection.Methods A total of 232 elderly pa-tients with CHF admitted and treated in this hospital from January 2023 to April 2024 were selected as the re-search subjects and divided into the CHF complicating pulmonary infection group(98 cases)and CHF group(134 cases)according to whether complicating pulmonary infection.One hundred healthy individuals who un-derwent physical examinations in this hospital during the same period were selected as the control group.The baseline data of all research subjects were collected;the sputum samples at admission were collected from the elderly patients with CHF complicating pulmonary infection for conducting the pathogenic bacterial culture;plasma FIB and serum ANGPTL4 levels in all research subjects were detected by enzyme-linked immunosor-bent assay(ELISA);serum ACTH level in all research subjects was detected by the chemiluminescence meth-od;the multivariate Logistic regression was used to analyze the influencing factors in elderly patients with CHF complicating pulmonary infection;the receiver operating characteristic(ROC)curve was drawn to ana-lyze the diagnostic value of plasma FIB and serum ACTH,ANGPTL4 alone and 3-item combination for elder-ly CHF patients with complicating pulmonary infection.Results A total of 116 strains of pathogenic bacteria were isolated from 98 elderly patients with CHF complicating pulmonary infection,among which Gram-nega-tive bacteria accounted for 72.41％and Gram-positive bacteria accounted for 27.59％.The proportion of com-plicating diabetes and the proportion of heart function grade Ⅳ in the CHF complicating pulmonary infection group were higher than those in the CHF group(P＜0.05).The plasma FIB and serum ACTH and AN-GPTL4 levels in the CHF complicating pulmonary infection group were higher than those in the CHF group and control group(P＜0.05);the serum ACTH and ANGPTL4 levels and plasma FIB level in the CHF group all were higher than those in the control group(P＜0.05).The multivariate Logistic regression analysis re-sults revealed that complicating diabetes mellitus,elevated plasma fibrinogen level and serum ACTH and AN-GPTL4 levels all were the risk factors for complicating pulmonary infection in elderly patients with CHF(P＜0.05).The ROC curve analysis results indicated that the area under the curve(AUC)of serum ACTH,ANGPTL4 and plasma FIB combination for diagnosing complicating pulmonary infection in elderly patients with CHF was 0.899,which was greater than that of FIB(Z=3.817,P＜0.001),ACTH(Z=3.447,P=0.001)and ANGPTL4(Z=3.681,P＜0.001)alone.Conclusion Pulmonary infections in elderly patients with CHF are mainly Gram-negative bacteria.In the patients with complicating pulmonary infections,plasma FIB,serum ACTH and ANGPTL4 levels are increased.The value of 3-indicator combination for diagnosing complicating pulmonary infections in elderly CHF patients is high.关键词
慢性心力衰竭/肺部感染/病原学/纤维蛋白原/促肾上腺皮质激素/血管生成素样蛋白4/老年人Key words
chronic heart failure/pulmonary infection/etiology/fibrinogen/adrenocorticotropic hormone/angiopoietin-like protein 4/elderly people分类
医药卫生引用本文复制引用
李佳红,谭化,赵雅丽,张秀敬,贾营..老年慢性心力衰竭合并肺部感染患者病原学分布及FIB、ACTH、ANGPTL4检测的临床意义[J].检验医学与临床,2025,22(22):3079-3083,3089,6.基金项目
河北省医学科学研究课题计划项目(20242374). （20242374）
