邱金玉 梁文京 黄满兴 包雷华

【摘要】目的研究老年心力衰竭并肺部感染患者血浆B型利钠肽（BNP）、白介素6（IL6）及降钙素原（PCT）的变化及其与心功能的相关性。

方法选取2012年9月～2013年9月就诊的100例老年心力衰竭并肺部感染患者作为观察组，另选取100名门诊健康老年人作为对照组，检测两组治疗前后血浆BNP、IL6及PCT浓度。

结果观察组治疗前血浆BNP、IL6及PCT浓度高于对照组，差异有统计学意义（P<0001）；观察组治疗前后血浆BNP、IL6及PCT变化明显，差异有统计学意义（P<0001）；不同心功能分级与血浆BNP、IL6及PCT呈正相关（r值分别为075，064，052，P<005）。

结论 老年心力衰竭并肺部感染患者血浆BNP、IL6及PCT明显升高，与病情严重程度呈正相关，具有临床提示意义。

【关键词】心力衰竭；肺部感染；心功能；BNP；IL6；PCT

中图分类号：R514.6；R563.1文献标识码：ADOI：10.3969/j.issn.10031383.2014.05.016

【Abstract】ObjectiveTo study changes of plasma Btype natriuretic peptide（BNP） and interleukin6（IL6）， and procalcitonin（PCT） in elderly patients with heart failure and pulmonary infection and such changes correlation with cardiac function.

Methods100 cases with senile heart failure and pulmonary infection，who were hospitalized from September，2012 to September，2013，were selected as observation group.100 healthy elderly people in the outpatient were selected as control group.Then，concentrations of plasma BNP，IL6 and PCT of two groups were measured before and after treatment.

Results Before treatment，the concentrations of plasma BNP，IL6 and PCT of the observation group were higher than those of the control group，and the difference had statistical significance（P<001）.Compared with those before treatment，the concentrations of plasma BNP，IL6 and PCT of the observation group changed obviously after treatment，so the difference was statistically significant（P<001）.Different cardiac functional gradings were positively correlated with plasma BNP，IL6 and PCT（r was 0.75，0.64 and 0.52 respectively，P<005）.

ConclusionPlasma BNP，IL6 and PCT in elderly patients with heart failure and pulmonary infection significantly increase， and they are positively correlated with the severity of the disease， which has clinical implications.

【Key words】heart failure；pulmonary infection；cardiac function；BNP；IL6；PCT

老年心力衰竭患者常合并肺部感染，导致病情加重[1]。研究表明，血浆B型利钠肽（BNP）水平比其他指标更能反映心功能变化，是心功能变化的敏感指标；白介素6（IL6）是机体炎性反应的指标，伴随机体感染的发生而升高；降钙素原（PCT）可以作为细菌感染的标志物，是快速诊断呼吸道细菌感染的指标之一，用于判定病情严重程度以及评价预后[2，3]。为研究老年心力衰竭并肺部感染患者血浆BNP、IL6及PCT浓度变化及其与心功能的关系，我院开展相关临床研究，现将结果报道如下。

1资料与方法

1.1临床资料选取 2012年9月～2013年9月于我院就诊的老年心力衰竭并肺部感染患者100例作为观察组，均确诊为心力衰竭，并伴有呼吸困难等肺部感染症状，X线检查有肺部感染征象。男56例，女44例，年龄61～82岁，平均（6845±536）岁，按照心功能分级，Ⅰ级15例，Ⅱ级48例，Ⅲ级21例，Ⅳ级16例；另选取100名门诊健康老年人作为对照组，男52例，女48例，年龄60～84岁，平均（6972±610）岁。……