1.Relationships Between Blood Levels of Osteopontin, Brain Natriuretic Peptide and Cardiac Function in Patients With Degenerative Heart Valve Disease
Chunzhi LI ; Suyan LI ; Qiong LIU ; Zhancong NIU
Chinese Circulation Journal 2016;31(5):459-462
Objective: To explore the relationships between blood levels of osteopontin (OPN), brain natriuretic peptide (BNP) and cardiac function in patient with degenerative heart valve disease (DHVD). Methods: Our research included in 2 groups: DHVD group,n=120 relevant patients treated in our hospital from 2013-12 to 2015-02 and Control group,n=30 healthy subjects from physical examination in the same period of time. Based on blood levels of OPN, DHVD patients were further divided into 2 sub-groups as Normal OPN sub-group, the patients with 18.8 ng/ml ≤OPN≤ 30.0 ng/ml,n=35 and High OPN sub-group, the patients with OPN>30.0 ng/ml,n=85. OPN levels at prior treatment (T0) and 3 days (T1), 1 week (T2), 2 weeks (T3) after treatment were compared between DHVD group and Control group; BNP levels, cardiac outcome (CO), cardiac index (CI) and left ventricular ejection fraction (LVEF) were also compared. The relationships between blood levels of OPN, BNP and cardiac function in DHVD patients were studied by Pearson correlation analysis. Results: Compared with Control group at T0 time point, High OPN sub-group showed increased blood levels of OPN and BNP, while decreased CO, CI and LVEF. Compared with Normal OPN sub-group, High OPN sub-group had the higher levels of OPN and BNP at all 4 time points, while lower levels of CO, CI and LVEF. In DHVD group, compared with T0 time point, OPN and BNP levels were decreased at T2 and T3 time points, while CO, CI and LVEF were increased, allP<0.05. Pearson correlation analysis presented that in DHVD patients, blood levels of OPN were positively related to BNP (r=0.936,P=0.00) and negatively related to CO, CI and LVEF (r=-0.869,r=-0.884 andr=-0.858 respectively, allP=0.00). Conclusion: DHVD patients had increased blood level of OPN which is related to BNP level and cardiac function; this might be because of OPN promoting heart valve calciifcation, inlfammatory reaction and myocardial injury. OPN could be used as a reference index for evaluating the cardiac function in DHVD patients.
2.The effects of serum C-reactive protein, B-natriuretic peptide and cholinesterase on prognosis in elderly patients with pulmonary infection
Zhancong NIU ; Junxiao LIU ; Shengjun YANG ; Yanxia WANG ; Hongying LIU
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2015;(4):378-381
Objective To investigate the effects of levels of serum C-reactive protein (CRP), B-natriuretic peptide (BNP) and cholinesterase (ChE) on prognosis of elderly patients with pulmonary infection.Methods Sixty cases aged ≥ 65 years old with lung infection admitted to Departments of Infectious Diseases and Respiration of Hebei Provincial People's Hospital from March 2012 to March 2014 were enrolled. According to the diagnostic criteria of pulmonary infection and the severity score (PSI) of pneumonia, the patients were classified into three groups with different grades of infectious severity (PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups), 20 cases in each group; in the same period, 20 elderly healthy people having accepted the physical examination in this hospital were designed as the healthy control group. Furthermore, according to the difference in prognosis, the patients were divided into a survival group (52 cases) and a death group (8 cases). The PSI scores, the levels of white blood cell count (WBC), D-Dimer, CRP, BNP and ChE, mortalities, times of stay in hospital were compared between the PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups and the healthy control group as well as between the survival and death groups.Results The periods of stay in hospital of patients with PSI Ⅳ and Ⅴ were much longer than that patients with PSI Ⅰ-Ⅲ (days: 14.7±2.1, 18.3±2.6 vs. 9.2±1.7, both P < 0.05), the degree of increase in time in the PSI Ⅴ group being the most significant. Before treatment, compared with the healthy control group, the PSI score, the levels of WBC, D-dimer, CRP and BNP were significantly increased, the level of ChE was markedly decreased in patients with PSI Ⅱ-Ⅲ, Ⅳ and Ⅴ groups, and along with the rise of PSI score the changes were more remarkable [PSI score: 78.9±13.7, 117.4±20.2, 152.1±34.8 vs. 51.3±7.9; WBC (×109/L): 11.4±1.4, 13.6±1.9, 16.7±2.2 vs. 8.9±1.1; D-Dimer (μg/L): 779.6±46.1, 1 068.2±142.6, 1 846.2±215.0 vs.348.3±31.8; CRP (mg/L): 30.1±3.7, 58.2±6.7, 74.7±9.2 vs. 6.8±0.9; BNP (ng/L): 1 057.4±205.1, 1 976.7±333.7, 2 437.7±468.9 vs. 115.8±21.7; ChE (U/L): 6 260±826, 3 390±437, 1 861±268 vs. 7 804±904, allP < 0.05]. The mortalities of groups PSI Ⅳ and PSI Ⅴwere more than that in group PSI Ⅱ - Ⅲ [10.0% (2/20), 30.0% (6/20) vs. 0]; there was no statistically significant difference in age between the survival group and death group (P > 0.05). Compared with the survival group, the PSI score, the levels of WBC, D-dimer, CRP and BNP after treatment in death group were markedly higher [PSI score: 141.5±23.3 vs. 97.6±18.2; WBC (×109/L): 15.9±1.9 vs. 12.1±1.8; D-Dimer (μg/L): 1 373.9±179.4 vs. 627.4±69.6; CRP (mg/L): 69.8±9.8 vs. 42.6±7.3; BNP (ng/L): 2 745.6±374.9 vs. 1 022.2±171.3; allP < 0.05], the level of ChE was significantly lower (U/L: 2 569±309 vs. 5 692±777,P < 0.05).Conclusion The serum levels of CRP, BNP and ChE in aged patients with pulmonary infection are helpful to the early diagnosis of disease severity, so as they have guiding significance in predicting prognosis.