慢性心力衰竭患者血脂、血浆NT-ProBNP、CTnⅠ和hs-CRP水平测定的临床分析  

The clinical analysis of blood lipid and plasma NT-proBNP, CTnⅠ and hs-CRP levels determined in patients with chronic heart failure

作　　者：郑青[1] 鲍逸民[1] 杨永青[2] 

机构地区：[1]南京医科大学附属苏州市立医院急诊科,苏州215002 [2]南京医科大学附属苏州市立医院核医学科,苏州215002

出　　处：《国际放射医学核医学杂志》2014年第4期232-234,265,共4页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的 测定慢性心力衰竭（CHF）患者的血脂、血浆N氨基末端脑钠肽前体（NT-ProB-NP）、心肌肌钙蛋白Ⅰ（CTnⅠ）和高敏C反应蛋白（hs-CRP）水平并进行临床分析.方法 采用生化法、荧光免疫分析法和放射免疫分析法测定165例CHF患者和60名正常对照者的血脂和血浆NT-ProBNP、CTnⅠ和hs-CRP水平,并进行比较性分析.结果 165例CHF患者血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平较60名正常对照者明显降低（TC：tⅡ=2.214,P＜0.05; tⅢ=2.873,P＜0.01; tⅣ=3.146; P＜0.01; TG：tⅡ=2.167,P＜0.05; tⅢ=2.863,P＜0.01; tⅣ=3.063,P＜0.01; LDL-C：tⅡ=2.147,P＜0.05; tⅢ=2.056,P＜0.05; tⅣ=2.184,P＜0.05; HDL-C：tⅡ=2.137,P＜0.05; tⅢ=2.256,P＜0.05; tⅣ=3.148,P＜0.01）.在生物标志物的测定中,165例CHF患者的血浆NT-ProBNP、CTnⅠ和hs-CRP水平与正常对照者之间的差异有统计学意义（NT-proBNP：tⅡ=2.096,P＞0.05; tⅢ=2.813,P＜0.01; tⅣ=4.135,P＜0.001;CTnⅠ：tⅡ=2.736,P＜0.01; tⅢ=2.962,P＜0.01; tⅣ=3.816,P＜0.001; hs-CRP：tⅡ=2.103,P＜0.05; tⅢ=2.956,P＜0.01;tⅣ=4.452,P＜0.001）,而且随左心室射血功能（LVEF）的降低而逐步升高.结论 CHF患者血脂水平（TC、TG、LDL-C和HDL-C）随LVEF的降低而降低,具有血脂代谢紊乱的现象;血浆生物标志物水平（NT-ProBNP、CTnⅠ和hs-CRP）随LVEF的降低而升高.Objective To measure the levels of blood lipid and plasma N-terminal pro-brain natriuretic peptide （NT-proBNP）,cardiac troponin Ⅰ （CTnⅠ） and high sensitive C-reaction protein （hsCRP） in patients with chronic heart failure （CHF）,and carry out clinical analysis.Methods The blood lipid and plasma NT-proBNP,CTnⅠ and hs-CRP levels in 165 patients with CHF and 60 controls were analyzed by chemistry,fluorescent immunoassay and radioimmunoassay,and then the results were analyzed and compared.Results The serum TC,TG,LDL-C and HDL-C levels in 165 patients with CHF were significantly lower than those of 60 controls （TC：t Ⅱ=2.214,P〈0.05; tⅢ=2.873,P〈0.01; tⅣ=3.146; P〈0.01;TG：t Ⅱ=2.167,P〈0.05; tⅢ=2.863,P〈0.01; tⅣ=3.063,P〈0.01; LDL-C：tⅡ=2.147,P〈0.05; tⅢ=2.056,P〈 0.05; tⅣ=2.184,P〈0.05; HDL-C：tⅡ=2.137,P〈0.05; tⅢ=2.256,P〈0.05; tⅣ=3.148,P〈0.01）.In biomarkers determining,the plasma NT-proBNP,CTnⅠ and hs-CRP levels in 165 patients with CHF were significantly higher than those of 60 controls （NT-proBNP：t Ⅱ=2.096,P〉0.05; tⅢ=2.813,P〈0.01; tⅣ=4.135,P〈0.001;CTnⅠ：tⅡ=2.736,P〈0.01; tⅢ=2.962,P〈0.01; tⅣ=3.816,P〈0.01 and hs-CRP：tⅡ=2.103,P〈0.05; tⅢ=2.956,P〈0.01; tⅣ=4.452,P〈0.001）,and the plasma three biomarker levels were increased with decreasing left ventricular ejection function（LVEF）.Conclusion The blood lipid （TC,TG,LDL-C and HDL-C） levels were decreased with decreasing LVEF and showing abnormal metabolism,but the plasma biomarkers levels were increased with decreasing LVEF.

关 键 词：心力衰竭 充血性 肌钙蛋白Ⅰ C反应蛋白质 血浆N氨基末端脑钠肽前体 放射免疫测定 荧光免疫测定 TROPONIN Ⅰ 

分 类 号：R541.6[医药卫生—心血管疾病]