慢性心力衰竭患者血清胱抑素C水平与疾病严重程度及预后的相关性研究  

Correlation Research between Serum CysC level and Degree of Disease Severity and Prognosis in Patients with CHF

作　　者：张少利[1] 王学惠[1] 陈志刚[1] 李燕[1] 

机构地区：[1]新乡医学院第一附属医院心内三科,河南卫辉453100

出　　处：《解放军医药杂志》2017年第3期46-48,56,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河南省科技发展计划资助(142300410192)

摘　　要：目的研究慢性心力衰竭(chronic heart failure,CHF)患者血清胱抑素C(CysC)水平与疾病严重程度及预后的相关性。方法选取2013年1月—2015年5月收治的92例CHF患者作为观察组,另选92例同期体检正常者作为对照组,比较对照组及观察组中不同心功能分级患者之间脑钠肽(BNP)、CysC、左心室射血分数(LVEF)和左心室舒张末期内径(LVEDd)水平,并比较观察组治疗前后以及有无发生不良心血管事件患者间BNP和CysC水平。结果不同心功能分级观察组BNP、CysC和LVEDd水平均高于对照组,LVEF低于对照组(P<0.05)。在观察组患者中,随着心功能等级的升高,BNP、CysC和LVEDd水平均明显升高,且LVEF逐渐降低(P<0.05)。不同心功能分级观察组患者治疗后BNP和CysC水平均低于治疗前(P<0.05)。治疗前后不同心功能分级观察组患者随着心功能等级的升高,BNP和CysC水平均明显升高(P<0.05)。发生不良心血管事件患者BNP和CysC水平均明显高于未发生不良心血管事件患者(P<0.001)。结论 CysC表达水平的高低与CHF的严重程度及预后有着密切的关系,可判断CHF的病情程度。Objective To investigate correlation between serum cystatin C （CysC） level and degree of disease severity and prognosis in patients with chronic heart failure （CHF）. Methods A total of 92 patients with CHF admitted between January 2013 and May 2015 were selected as observation group, and other 92 healthy people taking medical examination at the same period were chosen as control group. Levels of brain natriuretic peptide （BNP） , CysC, left ven- tricular ejection fraction （LVEF） and left ventricular end-diastolic dimension （LVEDd） were compared between control group and of patients with different cardiac function classification in observation group, and BNP and CysC levels in observation group before and after treatment as well as in patients with or without adverse cardiovascular events were com- pared. Results BNP, CysC and LVEDd levels were significantly higher, while LVEF level was significantly lower of pa- tients with different cardiac function classification in observation group than those in control group （P 〈 0.05）. In obser- vation group, BNP, CysC and LVEDd levels were significantly increased, and LVEF level was gradually decreased with increasing classification of cardiac function （P 〈 0.05 ）. BNP and CysC levels were lower after treatment than those be- fore treatment of patients with different cardiac function classification in observation group （P 〈 0.05 ）. BNP and CysC levels were significantly increased with increasing classification of cardiac function before and after treatment of patients with different cardiac function classification in observation group （P 〈 0.05）. BNP and CysC levels in patients with ad- verse cardiovascular events were significantly higher than those in patients without adverse cardiovascular events （P 〈 0. 001）. Conclusion CysC expression has inseparable relationship with degree of disease severity and prognosis of CHF, and it can be used to judge CHF condition.

关 键 词：慢性心力衰竭 胱抑素C 脑钠肽 预后 

分 类 号：R541.6[医药卫生—心血管疾病]