血清胱抑素C水平在老年慢性心衰患者中的临床价值及预后关系  

Clinical value and prognosis of serum cystatin C in elderly patients with chronic heart failure

作　　者：杨春华[1] 蔡伟[1] 龚燕[1] 庞小芬[1] YANG Chunhua;CAI Wei;GONG Yan;PANG Xiaofen(Department of Geriatrics,Ruijin Hospital Luwan Branch,Affiliated Hospital of Shanghai Jiao Tong University,Shanghai 200025,China)

机构地区：[1]上海交通大学附属瑞金医院卢湾分院老年科,上海200025

出　　处：《国际检验医学杂志》2020年第S01期8-11,共4页International Journal of Laboratory Medicine

基　　金：上海市黄浦区医疗卫生重点研究发展专科科研基金项目(HWZFK201801)。

摘　　要：目的探讨血清胱抑素C(Cys C)水平在老年慢性心力衰竭(CHF)患者中的临床价值及预后关系。方法选取2017年1月至2018年7月在本院老年科和心内科病房住院年龄≥60岁老年CHF患者共123例,按照美国纽约心脏病学会心功能分级标准(NYHA)分为Ⅱ级组、Ⅲ级组、Ⅳ级组以及Cys C正常组。入院后24 h内空腹静脉血检测血清Cys C浓度、血肌酐、B型利钠肽及彩色多普勒超声测量相关数据进行比较分析;同时记录及随访老年CHF患者住院期间及出院6个月内患者的病死率和因心衰再次住院率。结果老年CHF患者Ⅱ~Ⅳ级组的Cys C浓度、血肌酐、B型利钠肽及左心室射血分数水平与对照组比较差异有统计学意义(P<0.05),随心功能级别的增加血清Cys C浓度、血肌酐、B型利钠肽水平也有所增加,左心室射血分数则降低,且升高和降低在不同心功能分级组间两两比较差异有统计学意义(P<0.05)。不同病因老年CHF患者血Cys C浓度、血肌酐、B型利钠肽及左心室射血分数水平差异均无统计学意义(P>0.05)。随访老年CHF患者病死率和因心衰再次住院率Cys C组比低血清Cys C组比较明显增高,差异有统计学意义(P<0.05)。结论血清Cys C能为老年CHF患者临床早期判断心衰严重程度从而及早干预治疗提供有效依据,也是评估近期预后极有意义的指标。Objective To explore the clinical value and prognosis of serum cystatin C(Cys C)in elderly patients with chronic heart failure.Methods A total of 123 cases of CHF patients aged 60 or older were selected from the geriatric department and the cardiology department of the hospital from January 2017 to July 2018.According to the classification standards of the cardiology society of New York(NYHA),they were divided into groupⅡ,groupⅢ,groupⅣand Cys C normal group.The serum Cys C concentration,serum creatinine,B-type natriuretic peptide and color doppler ultrasonography were compared and analyzed within 24 hours after admission.At the same time,recorded and followed up the mortality and readmission rate due to heart failure of elderly CHF patients during hospitalization and 6 months after discharge.Results In elderly patients with CHF groupⅡ-Ⅳlevel concentration of Cys C,serum creatinine,blood B-type natriuretic peptide and left ventricular ejection fraction compared with control group,the difference was statistically significant(P<0.05),the levels of Cys C,creatinine and B-type natriuretic peptide were also increased with the increase of heart function level,left ventricular ejection fraction is lower,the difference of rising value and the falling value in the different classification of heart function compared to each other was statistically significant(P<0.05).The serum Cys C concentration,creatinine,B-type natriuretic peptide and left ventricular ejection fraction of elderly CHF patients with different etiologies were not statistically significant(P>0.05).The mortality and the rehospitalization rate due to heart failure of Follow-up elderly CHF patients were significantly higher in Cys C group than in low serum Cys C group,and the difference was statistically significant(P<0.05).Conclusion Serum Cys C can provide an effective basis for early clinical diagnosis of heart failure severity and early intervention treatment for elderly CHF patients,as well as a very significant indicator for short-term prognosis

关 键 词：胱抑素C 老年人 慢性心力衰竭 预后 

分 类 号：R54[医药卫生—心血管疾病]