Evaluation Value Of NT-proBNP,PCT And D Dimer In Elderly Patients With Community-acquired Pneumonia

Objective(s):The purpose of this study was to investigate the relationship between changes in serum levels of NT-proBNP(n-terminal brain natriuretic peptide precursor),PCT(procalcitonin)and D-dimer and the severity of the disease in elderly patients with CAP(community-acquired pneumonia).And further explore the evaluation value of NT-proBNP,PCT and D dimer level in elderly patients with CAP.Mothods:This retrospective study collected the clinical data of 175 elderly CAP patients admitted to the Department of general Practice,respiratory Department and respiratory Critical Care Department of the Second Affiliated Hospital of Kunming Medical University from January 2020 to January 2022,and collected the serum levels of NT-proBNP,PCT and D dimer in patients without the use of antibiotics upon admission.Three scoring systems were used to subgroup the severity of patients’ diseases.1.Patients were divided into low,medium and high-risk groups according to PSI score.90 patients in the low-risk group(grade l～ III)had PSI score < 90points;60cases in the medium-risk group(grade IV): PSI score 91-130 points;25patients in high-risk group(Grade V): PSI score > 130.2.The CURB-65 scoring system was used to divide the patients into low,medium and high risk groups.101 cases in the low risk group: CURB-65 scores were 0～1 points;50 cases in the medium-risk group:CURB-65 score was 2 points;24 patients in high-risk group:CURB-65 score was 3-5points.3.According to the survival and death of elderly patients with CAP during hospitalization,they were divided into death group(13cases)and survival group(162cases)The changes of NT-proBNP,PCT and D dimer levels among different groups and their correlation with PSI score and CURB-65 score were further analyzed.ROC curve was used to evaluate the efficacy of NT-proBNP,PCT and D dimer levels in the PSI score and CURB-65 score in the diagnosis of CAP in high-risk groups.Results:In PSI group,the levels of NT-proBNP,PCT and D dimer in high-risk and medium-risk groups were higher than those in low-risk group(P < 0.01),and the levels of NT-proBNP,PCT and D dimer in high-risk group were higher than those in medium-risk and low-risk groups(P < 0.01).In CURB-65 group,the levels of NT-proBNP,PCT and D dimer in low,medium and high risk groups were increased gradually(P < 0.01);The levels of NT-proBNP,PCT and D dimer in death group were higher than those in survival group(P < 0.01);PSI score and CURB-65 score were positively correlated with NT-proBNP,PCT and D dimer levels in all aged CAP patients(P < 0.01)In the PSI group,the area under ROC curve of NT-proBNP,PCT and D dimer levels in the diagnosis of high-risk elderly CAP patients were 0.898,0.903 and 0.840,respectively.In CURB-65 group,the areas under ROC curve of NT-proBNP,PCT and D dimer levels in the diagnosis of high-risk elderly CAP were0.909,0.897 and 0.856,respectively.Conclusion:1.Serum levels of NT-proBNP,PCT and D dimer are closely related to the severity of the disease in elderly patients with CAP The higher the level,the more serious the disease and the higher the mortality.2,NT-proBNP,PCT and D dimer level for high.risk elderly CAP have high diagnostic value,among which,the diagnostic value of NT-proBNP is the highest.3,NT-proBNP combined with PCT in the diagnosis of high-risk elderly CAP has a high specificity.