慢性心力衰竭患者血清hs—cTnT、NT—proBNP、hs-CRP表达水平与心功能相关性研究  

Study on the expression level and cardiac function of hs-cTnT, NT-proBNP, hs-CRP in serum of patients with chronic heart failure

作　　者：任凯[1] 冯津萍[1] 陈树涛[1] 郭玉军[1] 

机构地区：[1]天津市胸科医院心血管内科,天津市300222

出　　处：《中国心血管病研究》2017年第12期1094-1097,共4页Chinese Journal of Cardiovascular Research

基　　金：天津市卫生行业重点攻关项目（项目编号：14KG127）

摘　　要：目的 对慢性心力衰竭患者（CHF）血清中高敏肌钙蛋白T（hs-cTnT）、N未端脑钠肽前体（NT-proBNP）、超敏C反应蛋白（hs-CRP）表达水平与心功能的相关性.方法 选取2015年1月至2016年12月天津市胸科医院心血管内科收治的CHF患者200例和同期体检健康者70例作为研究对象.按NYHA心功能分级将CHF患者分为心功能Ⅰ/Ⅱ级70例、Ⅲ级65例、Ⅳ级65例,按照原发性心血管疾病分为缺血性心肌病54例、扩张型心肌病46例、高血压性心脏病51例、糖尿病性心肌病49例,分别检测对比各组血清hs-cTnT、NT-proBNP、hs-CRP表达水平及心功能指标LVMI、LAVI、LVEF.结果 CHF组中hs-cTnT、NT-proBNP、hs-CRP表达水平及心功能指标LVMI、LAVI显著高于健康对照组（P＜0.05）.随着心功能受损程度的增加,hs-cTnT、NT-proBNP、hs-CRP表达水平及心功能指标LVMI、LAVI也在逐渐增高（P＜0.05）;而LVEF显著低于对照组（P＜0.05）,且随着心功能受损程度的增加不断降低.血清hs-cTnT、NT-proBNP、hs-CRP水平与LVMI和LAVI呈正相关（r=0.214,0.303,0.689,0.473,P＜0.05）,而与LVEF呈负相关（r=-0.374,P＜0.05）.不同病因CHF患者血清hs-cTnT和NT-proBNP水平比较,具有显著差异（P＜0.05）,其中糖尿病性心肌病组、缺血性心肌病组及扩张型心肌病组患者血清hs-cTnT水平显著高于高血压性心脏病组（P＜0.05）患者;扩张型心肌病组患者血清hs-cTnT水平显著高于糖尿病性心肌病组和缺血性心肌病组患者.缺血性心肌病组和扩张型心肌病组患者血清NT-proBNP水平显著高于高血压性心脏病组和糖尿病性心肌病组患者（P＜0.05）,扩张型心肌病患者血清hs-cTnT水平显著高于缺血性心肌病组患者（P＜0.05）.结论 CHF患者血清hs-cTnT、NT-proBNP、hs-CRP表达水平随着病情加重明显升高,三者呈正相关,且与心功能指标也密切相关.Objective To study the expression level and cardiac function of hs-cTnT,NT-proBNP,hs-CRP in serum of patients with chronic heart failure.Methods In January 2015 and December 2015,Tianjin Chest Hospital cardiovascular internal medicine treated 200 cases of patients with CHF and the physical examination,70 cases of healthy subjects for the same period were selected as the research objects.According to the NY-HA heart function classification,CHF patients were divided into cardiac function Ⅰ / Ⅱ level of 70 cases,Ⅲ level of 65 cases,Ⅳ grade 65 cases.And according to the primary cardiovascular disease,they were divided into ischemic cardiomyopathy 54 cases,46 cases of DCM,hypertensive heart disease of 51 cases of diabetic cardiomyopathy in 49 cases.Contrast groups were detected in the serum of the hs-cTnT,NT-proBNP,hs-CRP expression level and cardiac function indexes LVMI,LAVI,LVEF.Results Hs-cTnT,NT-proBNP,hs-CRP expression level and cardiac function index LVMI and LAVI were significantly higher in CHF group than in healthy control group （P〈0.05）.With the increase of cardiac function,hs-cTnT,NT-proBNP,hs-CRP expression level and cardiac function index LVMI and LAVI were also gradually increasing （P〈0.05）.LVEF was significantly lower than the control group （P〈0.05）,and decreased with the increase of cardiac function.The serum hs-cTnT level was positively correlated with NT-proBNP,hs-CRP level and LVMI and LAVI （r=0.214,0.303,0.689,0.473,P〈 0.05）,while the LVEF was negatively correlated （r=-0.374,P〈0.05）.Different etiology CHF patients serum hs-cTnT and NT-proBNP level,with significant difference（P〈0.05）,of which the diabetic cardiomyopathy group,the patients with ischemic cardiomyopathy and dilated cardiomyopathy group hs-cTnT in serum were significantly higher than that of hypertensive heart disease group （P〈0.05）,while patients with DCM group hs-cTnT in serum were significantly higher than that of diabetic cardiomyopathy group and ischemic cardiomyopathy.In patients

关 键 词：慢性心力衰竭 高敏肌钙蛋白T N未端脑钠肽前体 超敏C反应蛋白 

分 类 号：R541.6[医药卫生—心血管疾病]