胱抑素C对慢性心力衰竭患者早期肾脏损害的预测价值  

The predictive value of serum cystatin C on early impairment of renal function in patients with chronic heart failure.

作　　者：王超权 田刚[2] 

机构地区：[1]绍兴市第四医院心内科,浙江绍兴312030 [2]西安交通大学医学院第一附属医院心内科,西安710061

出　　处：《中国实用内科杂志》2009年第S1期52-55,共4页Chinese Journal of Practical Internal Medicine

基　　金：陕西省科技攻关项目(2005K-14-G6(2))

摘　　要：目的探讨血清胱抑素C(CysC)与心功能分级及及早期肾脏损害的关系。方法 83例慢性心力衰竭(CHF)患者均符合NYHA心功能分级标准,心功能Ⅱ～Ⅳ级,33例心功能Ⅰ级,心力衰竭病史≥6个月。89例性别、年龄、居住地等与心衰患者匹配的健康者为对照组。采用颗粒增强免疫比浊法测定血清CysC的浓度,并测定血肌酐(Scr)、尿微量白蛋白(UMA)、左室射血分数(LVEF)及左心室舒张末内径(LVEDD)。结果心功能Ⅰ级者血清CysC水平较对照组显著升高。随着NYHA心功能分级级别增高,血清CysC水平明显升高。不同病因心衰组相互比较,血清CysC浓度差异无统计学意义。血清CysC与LVEF呈显著负相关,与LVEDD呈显著正相关。UMA水平与血清CysC水平呈显著正相关,心衰患者血清CysC的改变较Scr的改变出现迅速。结论血清CysC水平可能是反映心衰严重程度的标志之一,其对慢性心衰患者肾功能的评估优于血Scr。测定血CysC浓度对发现CHF患者早期肾损害以及评估预后具有一定临床意义。Objective To assess the predictive value of serum cystatin C(CysC)on early impairment of renal function in patients with chronic heart failure.Methods 83 patients with chronic heart failure(CHF) were measured up NYHA heart functional classification criteria,heart function classⅡ～Ⅳ,and 33 cases of heart function classⅠ. The history of heart failure≥6months.89 cases of gender,age,place of residence matched healthy control group.Using particles Immunoturbidimetry detected serum CysC concentration and serum creatinine(Scr),urinary albumin(UMA).Results The levels of serum CysC in heart function classⅠgroup were increased significantly than the control group(P<0.05).The levels of serum CysC respectively with the higher class of NYHA heart functional classification(classⅣcardiac function>classⅢ>classⅡrespectively).There were no significantly differences of CysC levels in heart failure groups with different causes.It was negatively correlated between CysC levels and LVEF,and it was positively correlated significantly between CysC levels and LVEDD.It was positively correlated between UMA and the levels of CysC.The changes of CysC level was rapidly than serum Scr.Conclusion CysC levels may reflect the signs of deterioration in heart function.To evaluate the renal function by used CysC is better than Scr in CHF.The level of serum CysC can predict early renal damage in CHF patients.

关 键 词：心力衰竭 胱抑素C 血肌酐 尿微量白蛋白 

分 类 号：R541.6[医药卫生—心血管疾病]