血浆氨基末端B型脑钠肽前体水平、中性粒细胞与淋巴细胞比值对急性CO中毒患者心肌损伤有预测价值
Predictive value of plasma NT-proBNP and the ratio of blood neutrophil to lymphocyte for myocardial injury in patients with acute CO poisoning

刘帅.血浆氨基末端B型脑钠肽前体水平、中性粒细胞与淋巴细胞比值对急性CO中毒患者心肌损伤有预测价值[J].内科急危重症杂志,2021,27(4):

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DOI：10.11768/nkjwzzzz20210418

中文关键词: 氨基末端B型脑钠肽前体中性粒细胞与淋巴细胞比值 CO中毒心肌损伤心力衰竭

英文关键词:

基金项目:河北省邢台市科技计划项目（No:2019ZC217）

作者	单位	E-mail
刘帅	邢台市第三医院急诊科	297761926@qq.com

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中文摘要:

目的：探讨基线血浆氨基末端B型脑钠肽前体（NT-proBNP）、血中性粒细胞与淋巴细胞比值（NLR）对急性CO中毒患者心肌损伤的预测作用。方法：回顾性分析2013年8月-2019年8月邢台市第三医院急诊科收治的172例急性CO中毒所致心肌损伤患者（心肌损伤组）的病历资料，另分析同期体检的64例健康者（对照组）的资料。比较2组基线血浆NT-proBNP、血NLR和血清肌钙蛋白Ⅰ（cTnⅠ）水平，比较心肌损伤组并发心力衰竭患者和未并发心力衰竭患者上述指标，分析并发心力衰竭患者基线血浆NT-proBNP、血NLR与血清cTnⅠ水平的相关性。结果：心肌损伤组基线血浆NT-proBNP、血NLR水平和血清cTnⅠ高于对照组（P均<0.05）；心肌损伤组心力衰竭发生率为11.63%；2组患者治疗3d后血浆NT-proBNP、血NLR和血清cTnⅠ水平低于入院后1h内（P均<0.05），治疗7d后低于治疗3d后（P均<0.05）；且与未并发心力衰竭患者比较，并发心力衰竭患者入院后1h内、治疗3d后和治疗7d后的血浆NT-proBNP、血NLR和血清cTnⅠ水平更高（P均<0.05）；各时间点基线血浆NT-proBNP、血NLR水平分别与血清cTnⅠ水平呈正相关（NT-proBNP的r值：0.825，0.807，0.795，NLR的r值：0.726，0.713，0.702，P均<0.05）。结论：急性CO中毒所致心肌损伤患者基线血浆NT-proBNP、血NLR水平和血清cTnⅠ水平均明显升高，且血浆NT-proBNP、血NLR与血清cTn Ⅰ水平呈正相关，可作为预测心肌损伤并发心力衰竭的指标之一。

英文摘要:

Objective: To explore the predictive effect of baseline plasma N-terminal B-type precursor brain natriuretic peptide (NT-proBNP) and blood neutrophil to lymphocyte ratio (NLR) in patients with myocardial injury caused by acute carbon monoxide (CO) poisoning. Methods: The data of 172 patients with myocardial injury caused by acute CO poisoning (myocardial injury group) admitted to the hospital were retrospectively analyzed, and the data of 64 healthy patients (healthy group) who underwent physical examination at the hospital during the same period were analyzed. The baseline plasma NT-proBNP, blood NLR levels and serum troponin Ⅰ (cTnⅠ) in myocardial injury group and healthy group were compared, the baseline plasma NT-proBNP, blood NLR and serum cTnⅠ in myocardial injury group with concurrent heart failure and non-complicated heart failure were compared, and the correlation between baseline plasma NT-proBNP, blood NLR levels and cTnⅠ levels in patients with myocardial injury and heart failure were analyzed. Results: The baseline plasma levels of NT-proBNP, blood NLR and serum cTnⅠ in the myocardial injury group were higher than those in the healthy group (P<0.05). The incidence of patients with concurrent heart failure in the myocardial injury group was 11.63%. The levels of NT-proBNP, blood NLR and cTnⅠ in the two groups after 3 days of treatment were lower than within 1 h after admission (P<0.05), and the levels of NT-proBNP, blood NLR and cTnⅠ were lower after 7 days of treatment than 3 days of treatment (P<0.05), the levels of NT-proBNP, blood NLR and cTnⅠ of patients with concurrent heart failure were higher than in patients without concomitant heart failure within 1 h after admission, 3 days after treatment, and 7 days after treatment (P<0.05). Baseline plasma NT-proBNP and blood NLR levels were positively correlated with cTnⅠ levels at each time point (r values: for NT-proBNP, 0.825, 0.807, 0.795; for blood NLR: 0.726, 0.713, 0.702, P<0.05). Conclusion: The levels of baseline plasma NT-proBNP, blood NLR and serum cTnⅠ levels in patients with myocardial injury caused by acute CO poisoning are increased, and NT-proBNP and blood NLR levels were positively correlated with cTnⅠ levels, which can be used as one of the indicators to predict myocardial injury complicated by heart failure.