cTnI、NT-proBNP、CA-125在老年慢性心力衰竭肺部感染诊断中的价值

姚尧; 陆宁; 陈建国

doi:10.16766/j.cnki.issn.1674-4152.003421

cTnI、NT-proBNP、CA-125在老年慢性心力衰竭肺部感染诊断中的价值

doi: 10.16766/j.cnki.issn.1674-4152.003421

姚尧¹,
陆宁^1, ,,
陈建国²

1.
芜湖市第一人民医院老年医学科，安徽芜湖 241000
2.
合肥市第一人民医院老年医学科，安徽合肥 230061

基金项目:

2020年安徽省自然科学基金项目 2008085MH257

详细信息

通讯作者:
陆宁，E-mail：524787215@qq.com

中图分类号: R541.6 R563.1
计量
- 文章访问数: 92
- HTML全文浏览量: 32
- PDF下载量: 7
- 被引次数: 0
出版历程
- 收稿日期: 2023-11-12
- 网络出版日期: 2024-05-27

Value of cTnI, NT-proBNP and CA-125 in diagnosis of pulmonary infection in elderly patients with chronic heart failure

YAO Yao¹,
LU Ning^{1
, ,},
CHEN Jianguo²

1.
Department of Geriatrics, Wuhu First People ' s Hospital, Wuhu, Anhui 241000, China

摘要

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。
- 老年慢性心力衰竭 /
- 肺部感染 /
- 心肌肌钙蛋白I /
- N末端前体脑利钠肽 /
- 糖类抗原-125
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.
- Elderly chronic heart failure /
- Lung infection /
- Cardiac troponin I /
- N-terminal precursor brain natriuretic peptide /
- Carbohydrate antigen-125

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图 1 血清cTnI、NT-proBNP、CA-125单独及联合检测诊断的ROC曲线

Figure 1. ROC curves for individual and combined detection of serum cTnI, NT-proBNP, and CA-125

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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		0.808^a	0.025^b	0.166^b
P值		0.668	0.975	0.847
注: ^a为χ²值，^b为F值。

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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±0.72^a	427.37±81.53^a	35.92±6.58^a
合并肺部感染组	40	3.92±1.25^ab	710.22±112.12^ab	50.25±5.34^ab
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。

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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±0.76^a	528.11±31.62^a	45.76±7.29^a
Ⅳ级	7	4.21±0.85^ab	711.20±40.26^ab	50.75±5.02^ab
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。

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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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