2021 年第 6 期 第 16 卷

血清降钙素原及B型脑钠肽联合检测辅助筛查未合并感染心力衰竭的价值

The value of combined detection of procalcitonin and brain natriuretic peptide in adjunctively screening heart failure without infection

作者：左路广郝瑞连晶晶詹明华张斌

英文作者：Zuo Luguang Hao Rui Lian Jingjing Zhan Minghua Zhang Bin

单位：河北北方学院附属第一医院检验科，河北省张家口市075000

英文单位：Department of Clinical Laboratory the First Affiliated Hospital of Hebei North University Hebei Province Zhangjiakou 075000 China

关键词：心力衰竭；降钙素原；B型脑钠肽；感染

英文关键词：Heartfailure;Procalcitonin;Brainnatriureticpeptide;Infection 

• 摘要：

• 目的 探讨降钙素原、B型脑钠肽(BNP)联合检测辅助筛查未合并感染心力衰竭的价值。方法 选取2019年1—12月河北北方学院附属第一医院收治的102例未合并感染的心力衰竭患者(未合并感染组)、100例合并感染的心力衰竭患者(合并感染组)，另选取同期体检健康志愿者(健康对照组)100例。收集3组的一般资料及血清降钙素原、BNP水平。分析血清降钙素原、BNP联合检测辅助筛查未合并感染心力衰竭的价值。结果 3组体重指数、血尿素氮、血肌酐、红细胞计数、血红蛋白水平比较，差异均无统计学意义（均P＞0.05）；合并感染组白细胞计数、C反应蛋白、体温水平均高于健康对照组和未合并感染组［（9.2±3.3）×109/L比（6.9±1.8）×109/L、（7.0±1.8）×109/L，（13.0±4.1）mg/L比（5.3±2.3）、（5.8±2.2）mg/L，（37.80±0.62）℃比（36.50±0.27）、（36.60±0.24）℃］（均P＜0.01）。合并感染组血清降钙素原、BNP水平均高于健康对照组和未合并感染组［5.32（4.58,6.15）μg/L比0.05（0.02,0.08）、1.37（0.81,2.32）μg/L，1 305（1 105,1 450）ng/L比55（35，79）、482（270，737）ng/L］，且未合并感染组均高于健康对照组(均P<0.01)。联合检测血清降钙素原、BNP辅助筛查未合并感染心力衰竭的敏感度、特异度、阳性预测值、阴性预测值、阳性似然比、比值比均高于降钙素原、BNP单独检测，漏诊率、误诊率、阴性似然比均低于血清降钙素原、BNP单独检测。结论 血清降钙素原、BNP联合检测对未合并感染心力衰竭患者的敏感度及特异度较高，可作为未合并感染心力衰竭的筛查指标。

• Objective  To investigate the value of combined detection of procalcitonin(PCT) and brain natriuretic peptide(BNP) in adjunctively screening heart failure without infection. Methods From January to December 2019, clinical data of 102 patients of heart failure without infection (non-infection group), 100 patients of heart failure with infection(infection group) admitted to the First Affiliated Hospital of Hebei North University, and another 100 healthy people undergoing physical examination at the same period(healthy control group) were retrospectively analyzed. The general data and serum levels of PCT and BNP of three groups were collected. The value of combined detection of PCT and BNP in adjunctively screening heart failure without infection was analyzed. Results There were no significant differences in body mass index, serum urea nitrogen, serum creatinine, red blood cell count and hemoglobin levels among the three groups（all P＞0.05）. Levels of white blood cell count, C-reactive protein and body temperature in infection group were higher than those in healthy control group and non-infection group［（9.2±3.3）×109/L vs （6.9±1.8）×109/L,（7.0±1.8）×109/L;（13.0±4.1）mg/L vs （5.3±2.3）,（5.8±2.2）mg/L;（37.80±0.62）℃ vs （36.50±0.27）,（36.60±0.24）℃］(all P<0.01). Serum levels of PCT and BNP in infection group were higher than those in healthy control group and non-infection group［5.32（4.58,6.15）μg/L vs 0.05（0.02,0.08）,1.37（0.81,2.32）μg/L; 1 305（1 105,1 450）ng/L vs 55（35,79）, 482（270,737）ng/L］, and those in non-infection group were higher than those in healthy control group(all P<0.01). The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and odds ratio of combined detection of serum PCT and BNP in adjunctively screening heart failure without infection were higher than those of PCT and BNP alone, and the missed diagnosis rate, misdiagnosis rate and negative likelihood ratio of combined detection of serum PCT and BNP were lower than those of PCT and BNP alone. Conclusion The combined detection of PCT and BNP has high sensitivity and specificity in patients of heart failure without infection. It can be used as screening reference for heart failure without infection.