充血性心力衰竭患者血清hs-CRP、cTnI及CK-MB的表达及其临床意义  

Expression of serum hs-CRP, cTnI, and CK-MB in patients with congestive heart failure and their clinical significance

作　　者：赵海专[1] 魏丽琴 ZHAO Haizhuan;WEI Liqin(Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;Wuhan No.1 Hospital,Wuhan 430022,Hubei,China)

机构地区：[1]武汉大学人民医院,湖北武汉430060 [2]武汉市第一医院,湖北武汉430022

出　　处：《武汉大学学报（医学版）》2022年第2期262-265,276,共5页Medical Journal of Wuhan University

基　　金：湖北省自然科学基金资助项目(编号:2016CKB885)。

摘　　要：目的:探讨充血性心力衰竭(CHF)患者血清超敏C-反应蛋白(hs-CRP)、心肌肌钙蛋白I(cTnI)及肌酸激酶同工酶(CK-MB)的表达及其临床意义。方法:选取2017年3月—2018年3月武汉大学人民医院收治的100例CHF患者为CHF组,同时选取48例健康者为对照组,利用酶联免疫吸附法(ELISA)测定CHF组和对照组的hs-CRP、cTnI及CK-MB水平。结果:CHF组血清hs-CRP、cTnI及CK-MB水平与病因无关,与患者心力衰竭的严重程度有关;血清hs-CRP与CK-MB、cTnI水平存在直线关系,呈正相关(r=0.872,0.801,P<0.05);血清hs-CRP、cTnI、CK-MB诊断CHF的最佳截断值分别为4.05、2.26、10.26,hs-CRP、cTnI、CK-MB以及三者联合预测CHF的ROC曲线下面积(AUC)分别为0.745、0.703、0.730、0.830,三者联合预测CHF的AUC大于hs-CRP(Z=2.526,P=0.012)、cTnI(Z=3.125,P=0.002)、CK-MB(Z=3.372,P<0.001)。结论:血清hs-CRP、cTnI、CK-MB水平可以判断CHF的心功能受损程度,且与病因无关;hs-CRP、cTnI、CK-MB可作为CHF早期诊断的标志物,三者联合应用能提高诊断效能。Objective: To explore expression of serum high-sensitivity C-reactive protein(hs-CRP), cardiac troponin I(cTnI), and creatine kinase isoenzyme(CK-MB) in patients with congestive heart failure(CHF) and their clinical significance. Methods: A total of 100 CHF patients who were admitted to Renmin Hospital of Wuhan University from March 2017 to March 2018 were enrolled as CHF group,while 48 healthy objects were enrolled as control group. The serum levels of hs-CRP, cTnI, and CK-MB in CHF group and control group were determined by enzyme-linked immunosorbent assay(ELISA). Results: The levels of serum hs-CRP, cTnI, and CK-MB in CHF group were not related to the causes of CHF, but they were related to the severity of heart failure. There were linear correlations between serum hs-CRP and CK-MB/cTnI levels(r=0. 872 and 0. 801, respectively, both P<0. 05). The optimal cut-off values of serum hs-CRP, cTnI, and CK-MB for the diagnosis of CHF were 4. 05, 2. 26, and 10. 26, respectively. The areas under ROC curve(AUC) of hs-CRP, cTnI,and CK-MB, and their combination for predicting CHF were 0. 745, 0. 703, 0. 730 and 0. 830, respectively. The AUC of their combination prediction was greater than that of hs-CRP(Z=2. 526, P=0. 012), cTnI(Z=3. 125, P=0. 002), and CK-MB single use(Z=3. 372, P<0. 001). Conclusion: The levels of serum hs-CRP, cTnI, and CK-MB can determine the degree of cardiac function impairment of CHF, which are not related to pathogeny. The hs-CRP, cTnI, and CK-MB can be applied as indicators for early diagnosis of CHF. The combination application of the three indicators can improve diagnostic efficiency.

关 键 词：充血性心力衰竭 超敏C-反应蛋白 肌钙蛋白I 肌酸激酶同工酶 

分 类 号：R542.22[医药卫生—心血管疾病]