Value of cTnI, NT-proBNP and CA-125 in diagnosis of pulmonary infection in elderly patients with chronic heart failure
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摘要:
目的 探讨心肌肌钙蛋白I(cTnI)、N末端前体脑利钠肽(NT-proBNP)、糖类抗原-125(CA-125)在老年慢性心力衰竭肺部感染诊断中的价值。 方法 选取芜湖市第一人民医院2020年1月—2023年6月收治的40例老年慢性心力衰竭肺部感染患者作为合并肺部感染组,同期40例老年单纯心力衰竭患者作为单纯心力衰竭组,同期40例老年健康体检者作为对照组。比较3组研究对象以及合并肺部感染组不同心功能分级血清cTnI、NT-proBNP、CA-125水平; ROC曲线分析合并肺部感染组血清cTnI、NT-proBNP、CA-125单独及联合检测的诊断效能。 结果 合并肺部感染组血清cTnI、NT-proBNP、CA-125均高于单纯心力衰竭组和对照组,单纯心力衰竭组高于对照组(P < 0.05);合并肺部感染组心功能Ⅳ级患者血清cTnI、NT-proBNP、CA-125均高于Ⅲ级和Ⅱ级,Ⅲ级高于Ⅱ级(P < 0.05);血清cTnI、NT-proBNP、CA-125单独及联合检测诊断老年慢性心力衰竭肺部感染的AUC值为0.935、0.977、0.996、1.000(P < 0.05)。 结论 老年慢性心力衰竭肺部感染患者血清cTnI、NT-proBNP、CA-125异常升高,三者联合检测可提高疾病诊断效能。 Abstract:Objective To investigate the diagnostic value of cardiac troponin I (cTnI), N-terminal precursor brain natriuretic peptide (NT-proBNP) and carbohydrate antigen-125 (CA-125) in elderly patients with chronic heart failure who have pulmonary infection. Methods During the period between January 2020 and June 2023, we selected 40 elderly patients with chronic heart failure and pulmonary infection as the combined lung infection group, 40 elderly patients with simple heart failure as the simple heart failure group, and 40 elderly patients who underwent physical examination as the control. The study compared the levels of serum cTnI, NT-proBNP, and CA-125 among the three groups, including the group with pulmonary infection. The diagnostic efficiency of serum cTnI, NT-proBNP and CA-125 in patients with pulmonary infection was analyzed by using the ROC curve. Results The levels of serum cTnI, NT-proBNP and CA-125 were higher in patients with pulmonary infection compared to those in the simple heart failure group and control group (P < 0.05). Additionally, the levels of serum cTnI, NT-proBNP and CA-125 were higher in grade Ⅳ patients with pulmonary infection were higher than those in grade Ⅲ and grade Ⅱ, and those in grade Ⅲ were higher than those in grade Ⅱ (P < 0.05). The serum cTnI, NT-proBNP and CA-125 AUC values for diagnosing pulmonary infection with chronic heart failure alone and in combination were 0.935, 0.977, 0.996 and 1.000, respectively (P < 0.05). Conclusion In elderly patients with chronic heart failure and pulmonary infection, serum levels of cTnI, NT-proBNP and CA-125 were found to be abnormally elevated. The combined detection of these three biomarkers could improve the diagnostic efficiency of the disease. -
表 1 3组研究对象一般资料比较
Table 1. Comparison of general data among the 3 groups of study subjects
组别 例数 性别(男/女, 例) 年龄(x±s,岁) BMI(x±s) 对照组 40 22/18 71.22±3.12 21.35±1.25 单纯心力衰竭组 40 24/16 71.38±3.16 21.42±1.28 合并肺部感染组 40 20/20 71.31±3.28 21.51±1.20 统计量 0.808a 0.025b 0.166b P值 0.668 0.975 0.847 注: a为χ2值,b为F值。 表 2 3组研究对象血清cTnI、NT-proBNP、CA-125水平比较(x±s)
Table 2. Comparison of serum levels of cTnI, NT-proBNP, and CA-125 among the three study groups (x±s)
组别 例数 cTnI(ng/mL) NT-proBNP(ng/L) CA-125(U/mL) 对照组 40 1.35±0.32 70.16±20.80 15.28±4.27 单纯心力衰竭组 40 2.50±0.72a 427.37±81.53a 35.92±6.58a 合并肺部感染组 40 3.92±1.25ab 710.22±112.12ab 50.25±5.34ab F值 91.090 626.225 411.852 P值 < 0.001 < 0.001 < 0.001 注:与对照组比较,aP < 0.05;与单纯心力衰竭组比较,bP < 0.05。 表 3 合并肺部感染组不同心功能分级血清cTnI、NT-proBNP、CA-125比较(x±s)
Table 3. Comparison of serum cTnI, NT-proBNP, and CA-125 in patients with pulmonary infection across various grades of cardiac function (x±s)
心功能分级 例数 cTnI(ng/mL) NT-proBNP(ng/L) CA-125(U/mL) Ⅱ级 20 1.84±0.35 366.54±21.51 40.74±6.34 Ⅲ级 13 2.82±0.76a 528.11±31.62a 45.76±7.29a Ⅳ级 7 4.21±0.85ab 711.20±40.26ab 50.75±5.02ab F值 41.232 401.181 6.805 P值 < 0.001 < 0.001 0.003 注:与Ⅱ级组比较,aP < 0.05;与Ⅲ级组比较,bP < 0.05。 表 4 血清cTnI、NT-proBNP、CA-125单独及联合检测的诊断效能
Table 4. Diagnostic efficacy of individual and combined detection of serum cTnI, NT-proBNP, and CA-125
项目 AUC SE 95% CI P值 cut-off值 约登指数 灵敏度(%) 特异度(%) cTnI 0.935 0.030 0.857~0.978 < 0.001 >1.859 ng/mL 0.850 85.00 100.00 NT-proBNP 0.977 0.012 0.899~0.989 < 0.001 >322.421 ng/L 0.850 97.50 89.50 CA-125 0.996 0.003 0.948~1.000 < 0.001 >22.019 U/mL 0.950 100.00 95.00 联合检测 1.000 < 0.001 0.955~1.000 < 0.001 1.000 100.00 100.00 -
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