摘要
目的探讨血清尿素氮与肌酐比值(UCR)与老年重症肺炎患者心功能的关系。方法回顾性选取2020年5月至2023年4月皖北煤电集团总医院收治的100例老年重症肺炎患者为病例组,另选取50例同期进行健康体检者为对照组。检测两组血清尿素氮(BUN)、肌酐(Cr)、UCR、心肌损伤指标[心肌肌钙蛋白I(cTnI)、氨基末端脑钠肽前体(NT-ProBNP)、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)]及心功能指标[左心室射血分数(LVEF)、心输出量(CO)、每搏输出量(SV)及心脏排血指数(CI)];病例组患者依据住院期间心功能不全发生情况分为心功能不全亚组与心功能正常亚组。比较病例组与对照组血清UCR、心肌损伤与心功能指标,比较心功能不全亚组与心功能正常亚组一般资料、心肌损伤与心功能指标,采用双变量Pearson相关性分析血清UCR与重症肺炎患者心功能的关系;用Logistic回归模型分析重症肺炎患者心功能不全的影响因素,采用受试者工作特征(ROC)曲线分析血清UCR预测重症肺炎患者心功能不全的价值。结果病例组BUN、UCR、cTnI、NT-ProBNP、CK、CK-MB水平大于对照组[(8.72±1.14)μmol/L比(6.41±0.76)μmol/L、125.00±19.75比86.12±12.02、0.04(0.03,0.05)μg/L比0.04(0.03,0.05)μg/L、(185.49±20.59)ng/L比(147.76±20.85)ng/L、(104.78±14.98)U/L比(99.33±15.07)U/L、(31.59±6.23)U/L比(29.13±5.76)U/L],Cr、LVEF、CO、SV、CI小于对照组[(70.22±5.76)μmol/L比(74.75±5.12)μmol/L、(59.72±2.41)%比(61.78±2.16)%、(3.93±0.43)L/min比(4.53±0.62)L/min、(59.82±6.12)ml比(62.23±7.22)ml、(2.95±0.30)L/(min·m^(2))比(3.06±0.33)L/(min·m^(2))],差异有统计学意义(P<0.05)。病例组患者住院期间21例患者出现心功能不全;心功能不全亚组入院时肺炎严重指数评分高于心功能正常亚组[(172.76±9.18)分比(168.24±8.81)分],血清BUN、UCR水平高于心功能正常亚组[(9.51±0.79)mmol/L比(8.51±1.13)mmol/L、141.62±9.89比120.59±19.39],血清
Objective To explore the relationship between serum urea nitrogen to creatinine ratio(UCR)and cardiac function in elderly patients with severe pneumonia.Methods A prospective selection of 100 elderly patients with severe pneumonia admitted to Group Wanbei General Hospital of Wanbei Coal Power from May 2020 to April 2023 was conducted as the case group,and an additional 50 patients who underwent health examinations in the hospital during the same period were selected as the control group.Serum urea nitrogen(BUN),creatinine(Cr),UCR value,myocardial injury indexes:cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-ProBNP),creatine kinase(CK),creatine kinase isoenzyme MB(CK-MB),and cardiac function indexes:left ventricular ejection fraction(LVEF),cardiac output(CO),stroke volume(SV)and cardiac output index(CI)were detected in the two groups.The patients in the case group were divided into two subgroups based on the occurrence of heart failure during hospitalization:the heart failure subgroup and the normal heart function subgroup.The serum UCR,myocardial injury and cardiac function indexes were compared between the case group and the control group.The general data,myocardial injury and cardiac function indexes were compared between the heart failure group and the normal heart function group.The relationship between serum UCR and cardiac function in patients with severe pneumonia was analyzed by bivariate Pearson correlation.Logistic regression model was used to analyze the influencing factors of cardiac dysfunction in patients with severe pneumonia,and using receiver operating characteristic(ROC)curve to analyze the value of serum UCR in predicting cardiac dysfunction in patients with severe pneumonia.Results The values of BUN,UCR,cTnI,NT-ProBNP,CK and CK-MB in the case group were higher than those in the control group:(8.72±1.14)μmol/L vs.(6.41±0.76)μmol/L,125.00±19.75 vs.86.12±12.02,0.04(0.03,0.05)μg/L vs.0.04(0.03,0.05)μg/L,(185.49±20.59)ng/L vs.(147.76±20.85)ng/L,(104.78±14.98)U/L vs.
作者
曹继飞
李莫振
蔡振华
王亮亮
王磊
Cao Jifei;Li Mozhen;Cai Zhenhua;Wang Liangliang;Wang Lei(Surgical Intensive Care Unit,Group Wanbei General Hospital of Wanbei Coal Power,Suzhou 234000,China)
出处
《中国医师进修杂志》
2024年第11期1001-1007,共7页
Chinese Journal of Postgraduates of Medicine
关键词
肺炎
老年人
血尿素氮
肌酸酐
心功能
Pneumonia
Aged
Blood urea nitrogen
Creatinine
Cardiac function
