Analysis Of Influencing Factors Of Serum NT-proBNP In Elderly Patients With Sepsis

Objective To investigate the influencing factors of NT-pro BNP in elderly patients with sepsis.Methods A cross-sectional study was used to analyze 114 elderly sepsis patients admitted to our hospital from October 2017 to December 2019.According to whether the serum NT-pro BNP level of the patients was increased at the time of diagnosis and admission,they were divided into observation group(NT-pro BNP increased)60 cases and 54 cases in the control group(NT-pro BNP normal).Collected the patient’s demographic characteristics and past medical history,body mass index(BMI),presence or absence of septic shock,SOFA score,APACHE II score,etc..The patients’ peripheral venous blood was collected at admission and submitted for examination of serum creatinine,myocardial injury markers: creatine kinase isoenzyme(CK-MB),cardiac troponin I(c Tn I),inflammatory index: endotoxin,procalcitonin(PCT),C-reactive protein(CRP),myocardial inhibitory factor: tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)levels.At the same time,patients’ peripheral venous blood was collected and submitted for serum myocardial autoimmune antibodies: anti-β1adrenergic receptor antibody(β1AAB),anti-M2 cholinergic receptor antibody(M2-AA)level.T-test,rank sum test and chi square test were used to compare the above indexes between the two groups.Logistic multiple regression was used to analyze the factors affecting the increase in serum NT-pro BNP in elderly patients with sepsis.Results The observation group and the control group had no statistics in age,gender,BMI,smoking history,diabetes history,hypertension history,coronary heart disease history(P>0.05).The proportion of septic shock,SOFA score and APACHE II score in the observation group were significantly higher than those in the control group.In terms of myocardial injury markers,the CK-MB and c Tn I indexes in the observation group were significantly higher than those of the control group(P<0.01).In terms of inflammation indexes,the PCT and CRP indexes in the observation group were significantly higher than that in the control group(P<0.01),but there was no significant difference in endotoxin(P>0.05).The two groups also had significant differences in myocardial inhibitory factors.The levels of serum IL-1β and TNF-α in the observation group were significantly higher than those in the control group(P<0.01).In terms of myocardial autoimmune antibodies,the levels of serum β1AAB and M2-AA in the observation group were significantly higher than those in the control group(P<0.01).In terms of renal function,the creatinine clearance(Ccr)level in the observation group was significantly lower than that in the control group(P<0.01).Logistic multiple regression analysis showed that the level of NT-pro BNP in elderly patients with sepsis was correlated with c Tn I positive(OR value 16.8121),PCT(OR value 1.4578),and IL-1β(OR value 1.1398)was positively correlated,and the level of NT-pro BNP was negatively correlated with BMI(OR value 0.7441),and Ccr(OR value 0.8983).The above differences were statistically significant(P<0.05).Conclusion In addition to the causes of heart failure,the increase of NT pro BNP in elderly patients with sepsis is related to BMI,c Tn I positive,PCT,IL-1 β and Ccr.The above indexes may be the influencing factors of the increase of NT pro BNP in elderly patients with sepsis,but these findings need to be further verified by prospective studies with a larger sample size.