陈旧性心肌梗死患者B型脑钠肽联合血清胱抑素C测定的临床意义  

Predictive value of serum cystatin C and B-type natriuretic peptide in patients with old myocardial infarction

作　　者：宗文仓 孔令军 傅向华[2] 

机构地区：[1]河北省玉田医院心内科,河北玉田064100 [2]河北医科大学第二医院,河北石家庄050000

出　　处：《海南医学》2015年第7期1007-1009,共3页Hainan Medical Journal

基　　金：河北省唐山市科学技术研究与发展指导计划(编号:10130265C)

摘　　要：目的评价B型脑钠肽（B-type natriuretic peptide）联合血清胱抑素C（Serum cystatin C,Cys C）在陈旧性心肌梗死患者中临床意义。方法连续入选2013年1~11月我院收治的陈旧性心肌梗死患者244例,根据NYHA分级标准评价患者心功能,分为非心衰组（NYHA心功能Ⅰ级）、心衰组（NYHA心功能Ⅱ~Ⅳ级）。入院后记录患者性别、年龄、高血压病、糖尿病、心肌梗死类型、NYHA分级等一般资料。入院即刻测定Cys C、BNP水平,两周内测定左室舒张末内径（LVEDD）、左室射血分数（LVEF）。结果两组患者在性别、高血压、糖尿病、LDL-C等方面比较,差异均无统计学意义（P〉0.05）。与非心衰组比较,心衰组年龄偏大,陈旧性前壁心肌梗死比率高,血清Cys C水平升高,BNP水平升高,左室舒张末内径大,左室射血分数比较低,差异有统计学意义（P〈0.01）。相关分析显示,胱抑素C与LVEF呈直线相关（P〈0.01）。二项Logistic回归分析显示,血清Cys C（OR=12.51,P=0.000）、陈旧性前壁心肌梗（OR=3.857,P=0.000）、年龄（OR=3.272,P=0.000）是陈旧性心肌梗死发生心力衰竭的相关危险因素。结论陈旧性心肌梗死患者Cys C对心力衰竭具有很好的预测价值,BNP联合Cys C可进一步评价患者血流动力学状态。Objective To evaluate the predictive value of serum cystatin C （CysC） and B-type natriuretic peptide （BNP） in patients with old myocardial infarction. Methods A total of 244 patients with old myocardial in-farction in our hospital from Jan. 2013 to Nov. 2013 were included, which were divided into non-heart failure group （NYHA classⅠ） and heart failure group （NYHA classⅡ~Ⅳ）. The general data of patients at admission, includinggender, age, hypertension, diabetes, type of myocardial infarction, NYHA classification, were recorded. The level of Cys C, BNP, left ventricular end-diastolic dimension （LVEDD） and left ventricular ejection fraction （LVEF） were ob-served. Results There was no statistically significant difference between the two groups in gender, hypertension, dia-betes, LDL-C （P〉0.05）. Compared with non-heart failure group, the level of Cys C, BNP, mean age, rate of anterior wall myocardial infarction in heart failure group were all significantly higher （P〈0.05）. The LVEDD in the heart fail-ure group were larger, and LVEF were lower （P〈0.01）. Correlation analysis indicated that there was linear correlation between Cys C and LVEF （P〈0.01）. Logistic regression analysis indicated that Cys C （OR=12.51, P=0.000）, old ante-rior myocardial infarction （OR=3.857, P=0.000） and age （OR=3.272, P=0.000） were the independent risk factors of heart failure in patients with old myocardial infarction. Conclusion Cys C could predict heart failure in patients with old myocardial infarction, and BNP combined with CysC can further evaluate the hemodynamic status of the patients.

关 键 词：心肌梗死 B-型脑钠肽 胱抑素C 

分 类 号：R542.22[医药卫生—心血管疾病]