血清 NT-proBNP、HBDH 诊断老年脓毒症继发 心功能不全的价值.

Objective To evaluate the value of N-terminal pro brain natriuretic peptide (NT-proBNP) and hydroxybutyrate dehydrogenase (HBDH) in diagnosing secondary heart failure in elderly patients with sepsis. Methods A case control study was conducted, with 80 elderly patients with sepsis from January 2020 to December 2021 as the study subjects. Patients were divided into a heart failure group (36 cases) and a non heart failure group (44 cases) based on whether they had concurrent heart failure. The echocardiographic indicators, NT-proBNP, HBDH, and levels of inflammatory factors between the two groups were compared. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of echocardiographic indicators, NT-proBNP, and HBDH in sepsis with concurrent heart failure. Results The left ventricular ejection fractions (LVEF), stroke volume variation (SVV), cardiac output (CO), fraction shortening (FS), and mitral early diastolic inflow velocity/mitral late diastolic inflow velocity (E/A) values of the heart failure group were significantly lower than those of the non heart failure group, with statistically significant differences (P<0.05). The NT-proBNP, HBDH, interleukin (IL-6), tumor necrosis factor (TNF-a), procalcitonin (PCT) values, APACHE II scores, and Sofa scores of the heart failure group were significantly higher than those of the non-heart failure group, with statistically significant differences (P<0.05). There was no statistically significant difference in C-reactive protein (CRP) levels between the two groups (P>0.05). For the 36 patients with sepsis and concurrent heart function damage, the NT-proBNP values were negatively correlated with LVEF, SVV, CO, FS, and E/A (P<0.05); and HBDH values were negatively correlated with LVEF and FS (P<0.05). The sensitivities of NT-proBNP, HBDH, and NT-proBNP + HBDH in diagnosing sepsis with concurrent heart failure were 76. 17%, 48.52%, and 92.41%, respectively, and the specificities were 91. 90%, 89. 20%, and 84.58%, respectively. The area under the ROC curve (AUC) were 0.893, 0.757, and 0.944, respectively. Conclusion The diagnostic efficacy of NT-proBNP and HBDH alone for predicting heart failure in patients with sepsis is limited. The combined use of NT proBNP and HBDH has high clinical value in diagnosing sepsis with concurrent heart failure and is significantly correlated with cardiac function indicators. In clinical practice, NT-proBNP and HBDH results may be considered in conjunction with ultrasound diagnosis to determine whether patients with sepsis have concurrent heart failure. [ABSTRACT FROM AUTHOR]