徐立彦,李晨,王华,詹燕
XU Liyan,LI Chen,WANG Hua,ZHAN Yan

• 1:甘孜藏族自治州人民医院心血管内科
• 2:四川大学华西医院心内科
• 3:甘孜藏族自治州人民医院超声科

摘要(Abstract)：

目的:探讨慢性心力衰竭合并肺部感染患者心肌酶谱4项、炎症因子水平的变化及临床意义。方法:198例慢性心衰患者分为研究组(存在肺部感染,n=143)与对照组(无肺部感染,n=55),比较2组患者入院治疗前的血清心肌酶谱4项[肌酸激酶同工酶(CKMB)、谷草转氨酶(AST)、肌酸激酶(CK)、乳酸脱氢酶(LDH)]水平及炎症因子[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平,采用接受者操作特性曲线(ROC)的曲线下面积(AUC)判断心肌酶谱、炎症因子对肺部感染的诊断价值,采用Pearson分析研究组患者血清4种心肌酶谱与3项炎症因子的相关性。结果:研究组患者血清CKMB、AST、CK及LDH均明显高于对照组,差异有统计学意义(P <0. 05);研究组患者血清TNF-α、CRP及IL-6水平指标均明显高于对照组(P <0. 05);心肌谱酶4项及炎症因子均可以用于肺部感染诊断(AUC> 0. 7),但炎症因子TNF-α、CRP及IL-6(AUC=0. 815、0. 854及0. 804)的诊断价值优于CKMB、AST、CK、LDH(AUC=0. 726、0. 704、0. 743及0. 783);Pearson相关分析结果显示,心肌酶谱CKMB、AST、CK、LDH与炎症因子TNF-α、CRP、IL-6两两间均存在正相关关系(P <0. 05)。结论:慢性心力衰竭合并肺部感染患者心肌酶谱与炎症因子水平异常上升,其水平变化可用于评估患者慢性心力衰竭合并肺部感染情况。
Objective: To investigate the effect of pulmonary infection on expression levels of four myocardial enzymes and inflammatory factors in patients with chronic heart failure. Methods: Based on pulmonary infection,198 patients with chronic heart failure were divided into a study group( the presence of pulmonary infection,n = 143) and a control group( the absence of pulmonary infection,n =55). We measured serum four myocardial enzymes including creatine kinase isoenzyme( CKMB),aspartate aminotransferase( AST),creatine kinase( CK) and lactate dehydrogenase( LDH). In addition,tumor necrosis factor-α( TNF-α),C reaction Protein( CRP) and interleukin-6( IL-6) ]levels were assayed. Area under curve( AUC) of ROC curve was used to determine the value of myocardial enzymes and inflammatory factors in diagnosing pulmonary infection. Pearson correlation analysis was used to analyze the correlation between the four myocardial enzymes and three inflammatory factors. Results: The levels of serum CKMB,AST,CK,LDH,TNF-α,CRP and IL-6 were significantly higher in study group than those in control group( P < 0. 05). These four myocardial enzymes and inflammatory factors can be used for diagnosing pulmonary infection( AUC > 0. 7),but the diagnostic values of TNF-α,CRP and IL-6( AUC = 0. 815,0. 854 and 0. 804) were superior to CKMB,AST,CK and LDH( AUC = 0. 726,0. 704,0. 743 and 0. 783). Pearson correlation analysis showed that CKMB,AST,CK and LDH were positively correlated with TNF-α and CRP IL-6( P < 0.05),respectively. Conclusion: The levels of myocardial enzymes and inflammatory factors in patients with chronic heart failure are significantly elevated in the presence of lung infection. These changes can be used to evaluate whether patients with chronic heart failure have pulmonary infection.

关键词(KeyWords)： 心力衰竭;肺部感染;心肌酶谱;炎症因子;临床意义;相关性
heart failure;pulmonary infection;myocardial enzyme;inflammatory factors;clinical significance;correlation

Abstract:

Keywords:

基金项目(Foundation): 四川省科技支撑计划项目(2018SZ0018)

作者(Author): 徐立彦,李晨,王华,詹燕
XU Liyan,LI Chen,WANG Hua,ZHAN Yan

DOI: 10.19367/j.cnki.2096-8388.2020.05.020

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