我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

降钙素原与白介素6与急性心力衰竭继发肺部感染的关系

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第3期
页码:
323-326
栏目:
临床研究
出版日期:
2014-03-20

文章信息/Info

Title:
Effects of serum plasma procalcitonin and interleukin6 in evaluation of the severity of acute heart failure with secondary pulmonary infection
作者:
王 浩1; 李 霞2; 林良毅1; 王 萍1; 林少华3
(1.荣成市中医院心内科，山东 荣成 264300；
2.济宁市第一人民医院肾内科，山东 济宁 272000；
3.荣成市人民医院心内科，山东 荣成 264300)
Author(s):
WANG Hao1;  LI Xia2;  LIN Liang yi1;  WANG Ping1;  LIN Shao hua3
(1.Department of Cardiology, Hospital of Traditional Chinese Medicine, Rongcheng 264300, Shandong, China;
2.Department of Nephrology, Jining First People’s Hospital, Jining 272000, Shandong, China;
3.Department of Cardiology, Rongcheng People’s Hospital, Rongcheng 264300, Shandong, China)
关键词:
降钙素原; 心力衰竭; 急性
Keywords:
procalcitonin;  heart failure;  acute
分类号:
R541.6
DOI:
-
文献标识码:
A
摘要:
目的:观察分析血清降钙素原（PCT）与白介素6（IL-6）与急性心力衰竭(心衰)并发肺部感染中的关联性。方法:将急性心衰患者184例分别于发病后第1、2、3、5天抽取静脉血， 检测血清IL-6、PCT的变化，同时依据患者临床肺部感染评分及痰培养结果将患者分为单纯心衰组与心衰并发肺部感染组，分析两组患者IL-6、PCT动态变化的意义。结果:心衰发生后第1、2天单纯心衰组与并发肺部感染组炎性反应指标较正常值明显增高。单纯心衰组发生后第2天PCT达到高峰，第3、5天PCT明显下降，降低幅度大于50%。但第3天单纯心衰组有59%患者血清PCT≥2.0 μg/L;而继发肺部感染组第1、2天血清PCT水平也表现明显升高，两组比较，差异无统计学意义。但第3天及第5天患者血清PCT水平持续升高或下降幅度＜30%。IL-6的动态变化：单纯心衰组发生后IL-6缓慢上升，第3天白IL-6达到高峰，持续升高至第5天下降不明显；而肺部感染组各时点观察IL-6水平持续升高，两组比较，差异无统计学意义。结论:急性心衰发生后，血清PCT水平的动态变化与继发肺部感染有关联。
Abstract:
AIM:To investigate the effects of serum plasma procalcitonin and interleukin-6 in evaluating the severity of acute heart failure with secondary pulmonary infection. METHODS: A total of 184 patients with acute heart failure were included in the study. Based on the clinical pulmonary infection scores and sputum culture results, patients were divided into acute heart failure group and heart failure with secondary pulmonary infection group. Venous blood was collected from patients 1, 2, 3, and 5 days after onset of heart failure and serum interleukin-6 (IL-6) and procalcitonin (PCT) changes were detected. RESULTS: On the first and second days after the occurrence of heart failure, the inflammatory response indicators in both groups were significantly higher than normal. Procalcitonin (PCT) levels peaked on the second day after onset in acute heart failure group and decreased significantly on the third and fifth day. The rate of decrease was >50%. On the third day, serum procalcitonin was ≥2.0 μg/L in 59% of the patients in the acute heart failure group. Serum procalcitonin levels were also significantly higher in heart failure with secondary pulmonary infection group on the first and second days. No statistically significant difference was observed between groups. Serum procalcitonin levels kept increasing on the third and fifth days and/or the rate of decrease was <30%. The levels of interleukin-6 slowly increased in the two groups, peaked on the fifth day and the rate of decline was not obvious. No statistically significant difference was observed between groups (P<0.05). CONCLUSION: After acute heart failure, the dynamic changes of serum procalcitonin levels are helpful in predicting the severity and prognosis of heart failure.

参考文献/References

[1]张 涛,周 虹,王用金,等.降钙素原在急诊抗感染中的诊断意义[J].中华急诊医学杂志,2010,19(5):556-557.
[2]Jessup M,Abraham WT,Casey DE,et al.2009 focused update;ACCE/AHA Guidelines for the diagnosis and management of heart failure in adults;a report of the.American College of Cardiology Foundation/American Heart Association task force on practice guidelines;developed in collaboration with the international society for heart and lung transplanatation[J].Circulation,2009,119(14):1977-2016.
[3]叶应妩,王毓三.全国临床检验操作规程[M].第2版.南京:东南大学出版社,1997:655-658.
[4]Kafkas N,Venetsanou K,Patsilinakos S,et al.Procalcitonin in acutemyocardialinfarction[J].AcuteCardCare,2008,10(1):30-36.
[5]Jensen JU,Heslet L,Jensen TH,et al.Procalcitonin increase in early identification of critically ill patients at high risk of mortality[J].Crit Care Med,2006,34(10):2596-2602.
[6]Buratti T,Ricevuti G,Pechlaner C,et al.Plasma levels of procalcitonin and interleukin 6 in acute myocardial infarction[J].Inflammation,2001,25(2):97-100.
[7]Eloy O,Vauloup C, Therond P,et al.Procalcitonin level in deep-seated Candida infections[J].Ann Biol Clin,2001,59(4):502-505.
[8]Layios N,Lambermont B.Procalcitonin for antibiotic treatment in intensive care unit patients[J].Curr Infect Dis Rep,2013,15(5):394-399.
[9]丁海波，林其昌，陈公平,等.血清降钙素原在慢性阻塞性肺疾病急性加重期抗菌治疗中的指导作用[J].中华老年医学杂志,2012,31(5):396-398.
[10]Haaspera C,Kalmbacha M,dikos GD,et al.Prognostic value of procalcitonin and (or)interleukin-6 plasma levels after multiple trauma for the development of multi organ dysfunction syndrome or sepsis[J].Technol Health Care,2010,18(2):89-100.
[11]Yu ZB,Liu J,Qiu Y,et al.The accuracy of the procalcitonin test for the diagnosis of neonatal sepsis; A meta-analysis[J].Scand J Infect Dis,2010,42(10):723-733.
[12]Dahaba AA, Mdtzler H.Procalcitonin’s role in the sepsis cascade.Is procalcitonin a sepsis marker or mediator?[J].Minerva Anestesiol,2009,75(7-8):447-452.
[13]Iapichino G,Marzorati S,Umbrello M,et al.Daily monitoring of biomarkers of sepsis in complicated longterm ICU-patients;can it support treatment decisions?[J].Minerva Anestesiol,2010,76(10):814-823.
[14]降钙素原急诊临床应用专家共识组.降钙素原(PCT)急诊临床应用的专家共识[J].中华急诊医学杂志,2012,21(9):944-948.

备注/Memo

备注/Memo:
收稿日期：2013-09-05.
通讯作者：林少华，副主任医师，主要从事重症医学研究 Email：shaohuaself@163.com
作者简介：王浩，副主任医师 Email：linshaohua@outlook.com
更新日期/Last Update: 2014-03-21