慢性心力衰竭合并肺部感染患者血清降钙素原、血管紧张素Ⅱ、 人单核细胞趋化蛋白 -1 与心脏功能和预后不良的关系分析.

Objective: To investigate the relationship between serum procalcitonin (PCT), angiotensin II (Ang II) and human monocyte chemotactic protein-1 (MCP-1) and cardiac function and poor prognosis in patients with chronic heart failure (CHF) complicated with pulmonary infection. Methods: 94 patients with CHF complicated with pulmonary infection who were treated in our hospital from March 2018 to March 2020 were selected as the combined infection group, in the same period, 54 patients with CHF without complicated with pulmonary infection who were treated as the control group. The level of serum PCT was detected by chemiluminescence immunoassay, the levels of serum Ang II and MCP-1 were detected by enzyme-linked immunosorbent assay. The levels of serum PCT,Ang II, MCP-1 and cardiac function indexes left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), heart rate (HR) were compared between the two groups. The correlation between the levels of serum PCT, Ang II, MCP-1 and LVEF, LVESD, LVEDD, HR was analyzed in the combined infection group. After active treatment,patients in the combined infection group were divided into good prognosis group and poor prognosis group according to whether adverse cardiac events occurred during hospitalization and follow-up for 6 months. Univariate and multivariate Logistic regression models were used to analyze the prognostic factors of patients with CHF complicated with pulmonary infection. Results: The levels of PCT, Ang II,MCP-1, LVESD, LVEDD and HR in the combined infection group were higher than those in the control group (P<0.05), and the level of LVEF was lower than that in the control group (P<0.05) . The levels of serum PCT, Ang II and MCP-1 were negatively correlated with LVEF (P<0.05), and positively correlated with LVESD, LVEDD and HR (P<0.05). Univariate analysis showed that the prognosis of patients with CHF complicated with pulmonary infection was related to the course of heart failure, New York Heart Association (NYHA) cardiac function grade, N-terminal B-type natriuretic peptide (NT-proBNP), PCT, Ang II, MCP-1 levels (P<0.05) . Multivariate Logistic regression analysis showed that the course of heart failure > 6 years, NYHA cardiac function grade III and IV, NT-proBNP > 570 ng/L,PCT>3.27 μg/L, Ang II>68.47 ng/L and MCP-1>267.65 ng/L were the risk factors for the prognosis of patients with CHF complicated with pulmonary infection (P<0.05). Conclusion: The abnormal increase of the levels of serum PCT, Ang II and MCP-1 in patients with CHF complicated with pulmonary infection is related to the cardiac function and prognosis of patients, and which can be used as an auxiliary index for the evaluation of cardiac function and prognosis of patients. [ABSTRACT FROM AUTHOR]