Objective To detect and analyze the biochemical indexes of elderly patients with nosocomial pneumonia complicated by heart failure so as to find out the sensitive indexes to assess the cardiac functions. Methods Totally 80 elderly patients with nosocomial pneumonia who were definitely diagnosed as having chronic heart failure were recruited as the trial group, and another 80 with no chronic hear failure were chosen as controls. The bidirectional lateral flow immunoassay was used to detect the concentration of serum N - terminal - pro - brain natriuretic peptide ( NT - proBNP ); and AIA360 Automatic Enzyme Immunoassay System was taken to determine the contests of aspartate aminotransferase ( AST ), lactate dehydrogenase ( LDH ), crea-tine phosphate kinase - MB ( CK - MB ) and cardiac troponin I ( cTnl). The heart function classification was performed according to criteria of New York Heart Association ( NYHA ). Results The logNT - proBNP in the trial group was ( 3. 42 ± 0. 19 ) pg/ml, being significantly higher than ( 2. 65 ± 0. 16 ) pg/ml in the control group ( P < 0. 05 ). The assayed results of serum NT - proBNP consentations showed that ( 3. 72 ±0. 18 ) pg/ml of patients at NYHA Ⅳ grade > ( 3. 36 ±0. 14 ) pg/ml of patients at NYHAⅢ grade > ( 2. 88 ±0. 12 ) pg/ml of patients at NYHA Ⅱ grade ( F = 183. 36, P = 0. 00 ) . Conclusion The level of serum NT - proBNP in elderly patients with nosocomial pneumonia complicated by heart failure increases with the severity of the heart failure, which is a sensitive biomarker to evaluate heart function.%目的 检测医院获得性肺炎(HAP)伴心力衰竭(心衰)老年患者的生化指标并进行分析,以寻找评价心功能的敏感性指标.方法 选择明确诊断为慢性心衰的HAP老年患者80例作为观察组,不伴心衰者80例作为对照组.利用双向侧流免疫法检测血清氨基末端脑钠肽前体(NT-proBNP)浓度,血清天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白I(cTnI)用AIA360全自动荧光磁微粒酶免疫分析仪检测.心功能按照纽约心脏病协会(NYHA)心功能分级法分级.结果 HAP伴心衰老年患者NT-proBNP水平(logNT-proBNP(3.42±0.19)pg/ml)较对照组(logNT-proBNP(2.65±0.16)pg/ml)升高,差异有统计学意义(P＜0.05);心功能NYHA分级Ⅳ级患者的NT-proBNP水平(logNT-proBNP(3.72±0.18)pg/ml)＞Ⅲ级(logNT-proBNP(3.36±0.14)pg/ml)＞Ⅱ级(logNT-proBNP(2.88±0.12)pg/ml),差异有统计学意义(F=183.36,P=0.00).结论 HAP伴心衰老年患者血清NT-proBNP水平随着心衰严重程度的增加而升高,是评价心功能较为敏感的实验室指标.
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