血清HE4、Cystatin C及BNP与慢性心力衰竭病人心力衰竭严重程度及预后的相关性分析  

Correlation analysis of serum HE4,Cystatin C and BNP with the severity and prognosis of heart failure in patients with chronic heart failure

作　　者：王晓亮[1] 郑伟 赵娜 耿晓 WANG Xiao-liang;ZHENG Wei;ZHAO Na;GEN Xiao(Department of Clinical Laboratory,The First Hospital of Yulin,Yulin Shaanxi 719000;The Medical and Health Development Research Center of Yulin,Yulin Shaanxi 719000;Department of Clinical Laboratory,The Second Hospital of Yulin,Yulin Shaanxi 719000;Department of Clinical Laboratory,The Central Hospital of Taian,Taian Shandong 271000,China)

机构地区：[1]陕西省榆林市第一医院检验科,719000 [2]陕西省榆林市医药卫生健康发展研究中心,719000 [3]陕西省榆林市第二医院检验科,719000 [4]山东省泰安市中心医院检验科,271000

出　　处：《蚌埠医学院学报》2022年第10期1416-1420,共5页Journal of Bengbu Medical College

基　　金：山东省自然科学基金项目(ZR2014HL108)。

摘　　要：目的:探讨血清人附睾蛋白4(HE4)、胱抑素C(Cystatin C)和脑钠肽(BNP)与慢性心力衰竭病人的心力衰竭严重程度及预后的相关性。方法:收集120例慢性心力衰竭病人为研究对象。根据纽约心脏协会(NYHA)的心功能分级标准分为心功能Ⅱ级24例、Ⅲ级53例、Ⅳ级43例。根据病人是否死亡将病人进一步分为31例死亡组和89例存活组,并于同期随机选取75名健康体检者为对照组。采用酶联免疫吸附法检测各组血清HE4、Cystatin C及BNP水平,比较死亡组与存活组的各项临床指标。结果:心功能Ⅳ级病人血清HE4、Cystatin C及BNP水平最高,其次为心功能Ⅲ级和心功能Ⅱ级,对照组最低(P<0.01)。与存活组相比,死亡组血清HE4、Cystatin C及BNP水平明显升高,左心室射血分数(LVEF)明显明显下降(P<0.01)。血清HE4、Cystatin C及BNP是病人预后的主要危险因素(OR=1.999、2.333、1.809,P<0.01),而LVEF是保护因素(OR=0.734,P<0.01)。血清HE4、Cystatin C及BNP联合LVEF检测对病人预后的预测价值高于各指标单独检测。结论:血清HE4、Cystatin C及BNP水平升高与慢性心力衰竭病人的病情严重程度及预后密切相关,三项指标联合LVEF检测有助于预测不良预后发生风险,在慢性心力衰竭病人的诊治中具有一定临床价值。Objective:To investigate the correlation of serum human epididymal protein 4(HE4),Cystatin C and brain natriuretic peptide(BNP) with the severity and prognosis of heart failure in patients with chronic heart failure.Methods:A total of 120 patients with chronic heart failure were collected as subjects.According to the NYHA classification standard,patients were divided into 24 cases of class Ⅱ,53 cases of class Ⅲ and 43 cases of class Ⅳ.The patients were further divided into death group(n=31) and survival group(n=89) according to the death.Seventy-five healthy patients were randomly selected as the control group at the same time.Serum levels of HE4,Cystatin C and BNP in each group were determined by enzyme-linked immunosorbent assay.Results:Serum HE4,Cystatin C and BNP level in class Ⅳ patients were the highest,followed by class Ⅲ and Ⅱ,control group was the lowest(P<0.01).Compared with the control group,serum HE4,Cystatin C and BNP levels in the control group were significantly increased,and LVEF was significantly decreased(P<0.01).Serum HE4,Cystatin C and BNP were the major risk factors for poor prognosis(OR=1.999,2.333,1.809,P<0.01),while LVEF was the protective factor(OR=0.734,P<0.01).The predictive value of serum HE4,Cystatin C and BNP combined with LVEF was higher than those of each individual test.Conclusions:Elevated serum HE4,Cystatin C and BNP levels are closely related to the severity and prognosis of patients with chronic heart failure.The combination of three indicators and LVEF test is helpful to predict the risk of poor prognosis,which has certain clinical value in the diagnosis and treatment of chronic heart failure.

关 键 词：慢性心力衰竭 人附睾蛋白4 胱抑素C 脑钠肽 左心室射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]