关键词: 心功能, B型尿钠肽原, 全身性感染, 特异度, 经胸壁超声心动图, 灵敏度

Abstract:

Objective: To investigate the levels of B type natriuretic peptide fibrinogen (BNP) of the systemic infection patients with different cardiac function classifications, and to detect the ventricular structure and the hemodynamics and cardiac function of the patients by transthoracic echocardiography,and to clarify the characteristics of the cardiac function of patients with systemic infection.Methods: The clinical data of 114 patients with systemic infection were collected and analyzed retrospectively.All the patients were divided into heart failure group (n=35) and non-heart failure group (n=79)according to whether or not heart failure occured.The levels of plasma BNP were detected in all the patients,and the values of left ventricular end diastolic diameter (LVIDD) and left ventricular ejection fraction (LVEF) were detected by transthoracic echocardiography.The cardiac function classifications of all the patients were confirmed by the Killip classification method.The correlations between the cardiac function classifications and the levels of plasma BNP and the values of LVEF were analyzed.The diagnostic sensitivity and specificity of the patients with systemic infection complicated with heart failure were analyzed by BNP level detection,transthoracic echocardiography, and BNP level detection combined with transthoracic echocardiography, respectively.Results: Compared with non-heart failure group,the plasma BNP levels and LVIDD values of the patients in heart failure group were obviously increased(t=8.985,P=0.039; t=11.459, P=0.028),but the LVEF values were obviously decreased (t=9.852, P=0.031). The Killip classification of cardiac function had positive relationship with the plasma BNP levels in the patients with systemic infection (r=0.90,P<0.05); the Killip classification of cardiac function had negative relationship with the LVEF values in the patients with systemic infection (r=-0.785,P<0.05).The diagnostic sensitivity and specificity of the patients with systemic infection complicated with heart failure detected by BNP detection combined with transthoracic echocardiography were higher than those detected by other two detection methods alone(P<0.05).Conclusion: The diagnostic sensitivity and specificity of patients with systemic infection complicated with heart failure can be obviously improved by BNP detection combined with transthoracic echocardiography.

Key words: transthoracic echocardiography, B type natriuretic peptide, sensitivity, cardiac function, systemic infection, specificity