抗氧化应激对慢性心力衰竭患者CysC及Pro-BNP的影响及相关性  

Effect of Anti-oxidative Stress on CysC and Pro-BNP in Patients with Chronic Heart Failure and Their Correlation

作　　者：李杰[1] 张施明[1] 杨淑莲[1] LI Jie;ZHANG Shi-ming;YANG Shu-lian(Dept.of Cardiology,The 1st Affiliated Hospital of Guangxi University of Science and Technology,Liuzhou Guangxi545001,China)

机构地区：[1]广西科技大学第一附属医院心血管内科,广西柳州545001

出　　处：《昆明医科大学学报》2020年第1期31-36,共6页Journal of Kunming Medical University

基　　金：广西壮族自治区医疗卫生适宜技术开发与推广应用基金资助项目(S2017-006)。

摘　　要：目的探讨慢性心力衰竭患者经抗氧化应激治疗后对CysC及Pro-BNP变化的影响,以及与近期预后的相关性。方法选择广西科技大学第一附属医院2015年6月至2018年6月慢性心力衰竭患者(NYHAⅡ~Ⅳ级)126例为研究组,同期住院无心功能不全患者62例为对照组,分别收集2组患者年龄、性别、体重、身高等基线资料,心脏彩超评估心功能状态:左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左房舒张末期内径(LAD),并测定血清CysC、Pro-BNP、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、肌酐(Cr)、尿素氮(BUN)、尿酸(UA),随后分析所产生的临床意义。结果与对照组比较,LVEF、TC、HDL-C水平降低(P<0.05);LVEDD、LAD、TG、Cr、BUN水平均升高(P<0.05);心力衰竭组CysC及Pro-BNP水平显著升高(P<0.05);NYHA Ⅱ级组、Ⅲ级组、Ⅳ级组CysC及Pro-BNP水平显著升高(P<0.05)。经抗氧化应激治疗后,6个月内随访结果可见:抗氧化应激后HF组CysC及Pro-BNP水平仍高(P<0.05);治疗后各组CysC及Pro-BNP水平显著降低(P<0.05)。CysC与Pro-BNP、LAD、LVEDD、TG、Cr、BUN呈正相关;与LVEF、TC、HDL-C呈负相关。心力衰竭组患者再住院率及死亡率均高,而死亡率差异不具有统计学意义(P>0.05)。结论抗氧化应激治疗与血清CysC及Pro-BNP水平关系密切,具有负相关性,血清CysC及Pro-BNP水平与心力衰竭心功能程度具有密切相关性,可作为慢性心力衰竭患者近期再住院率及死亡率增加的预测因子。Objective To investigate the effects of anti-oxidative stress on the changes of CysC and Pro-BNP in patients with chronic heart failure,and the correlation with recent prognosis.Methods 126 patients with CHF(NYHA class II-IV)from 2015.6 to 2018.6 in our hospital were selected as the study group.62 patients with no cardiac dysfunction in the same period were selected as the control group.The age,sex and gender of the two groups were collected.Baseline data such as body weight and height,cardiac function assessment of cardiac function status:left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left atrial end-diastolic diameter(LAD),and determination of serum CysC,Pro-BNP,Total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),creatinine(Cr),urea nitrogen(BUN),uric acid(UA),followed by Analyze the clinical implications.Results Compared with the control group,LVEF,TC,HDL-C levels decreased,P<0.05;LVEDD,LAD,TG,Cr,BUN levels increased,P<0.05;heart failure group CysC and Pro-BNP levels significantly increased(P<0.05);The levels of CysC and Pro-BNP in NYHA class II group,NYHA class III group and NYHA class IV group were significantly increased(P<0.05).After anti-oxidative stress treatment,the results of follow-up within 6 months showed that the levels of CysC and Pro-BNP in HF group were still high after anti-oxidative stress(P<0.05);NYHA II group,NYHA after treatment The levels of CysC and Pro-BNP in the III group and NYHA class IV were significantly decreased(P<0.05).CysC was positively correlated with Pro-BNP,LAD,LVEDD,TG,Cr,BUN;negatively correlated with LVEF,TC and HDL-C.Re-hospitalization rate and mortality were higher in the heart failure group,and the mortality difference was not statistically significant(P>0.05).Conclusions Antioxidative stress therapy is closely related to serum CysC and Pro-BNP levels,and has a negative correlation.Serum CysC and Pro-BNP levels are closely related to heart failure in heart failure,and can be used

关 键 词：抗氧化应激 心力衰竭 胱抑素C B型钠尿肽前体 

分 类 号：R541.6[医药卫生—心血管疾病]