慢性心力衰竭患者血清半胱氨酸蛋白酶抑制剂C与血脂水平的相关性  

Correlation between serum cystatin C and lipid level in patients with chronic heart failure

作　　者：倪凤扬 项羽 NI Fengyang;XIANG Yu(Department of Cardiovascular Medicine,521 Hospital of Norinco Group,Xi’an 710065;Department of Cardiovascular Medicine,Shaanxi Provincial People’s Hospital,Xi’an 710068,China)

机构地区：[1]兵器工业五二一医院心血管内科,西安710065 [2]陕西省人民医院心血管内科,西安710068

出　　处：《中南大学学报（医学版）》2023年第1期34-39,共6页Journal of Central South University ：Medical Science

基　　金：陕西省创新人才推进计划青年科技新星项目(2020KJXX-086)。

摘　　要：目的:血清半胱氨酸蛋白酶抑制剂C(cystatin C,Cys C)、血脂水平均与慢性心力衰竭(chronic heart failure,CHF)的发生和发展有关,但对于CHF患者血脂水平与Cys C异常的相关性鲜有报道。本研究旨在探讨CHF患者血清Cys C水平与血脂水平的相关性,以期为CHF的临床诊断和治疗提供有价值的参考依据。方法:选取2017年10月至2018年7月于陕西省人民医院心血管内科住院治疗的336例CHF患者。根据患者血清Cys C的水平,将其分为Cys C正常组(n=180)和Cys C异常组(n=156)。比较2组患者的一般资料、实验室指标及心脏超声检查结果,采用Pearson相关分析评估Cys C与血脂指标等的相关性,选取与Cys C相关的指标进行logistic回归分析。结果:与Cys C正常组相比,Cys C异常组CHF患者的左室射血分数(left ventricular ejection fraction,LVEF)较低(P<0.001),年龄较大(P=0.030),糖尿病发病率和吸烟指数较高(分别P=0.002和P=0.003),血肌酐(serum creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)和总胆红素(total bilirubin,TBIL)水平较高(均P<0.001),而高密度脂蛋白(high density lipoprotein,HDL)、载脂蛋白(apolipoprotein,Apo)A和白蛋白(albumin,ALB)水平较低(分别P<0.001、P=0.001和P=0.003)。Pearson相关分析结果显示:血清Cys C水平与血小板计数、HDL、Apo A、ALB、LVEF呈线性负相关,与吸烟指数、平均血小板体积、中性粒细胞比例、BUN和TBIL呈线性正相关(均P<0.05)。多因素logistic回归分析结果显示:HDL水平下降是CHF患者血清Cys C异常的危险因素(OR=0.119,P=0.003),而Apo A不是其异常的影响因素(P=0.337)。结论:HDL可能是CHF患者血清Cys C异常唯一相关的血脂学指标。Objective:Serum cystatin C(Cys C)and blood lipid levels are related to the occurrence and development of chronic heart failure(CHF).However,there are few reports on the correlation between blood lipid level and serum Cys C level in patients with CHF.The aim of this study is to explore the correlation between serum Cys C level and blood lipid level in patients with CHF,and to provide valuable reference for clinical diagnosis and treatment of CHF.Methods:A total of 336 CHF patients who were hospitalized in the Department of Cardiovascular Medicine of Shaanxi Provincial People’s Hospital from October 2017 to July 2018 were included and they were divided into a Cys C normal group(n=180)and a Cys C abnormal group(n=156)according to serum Cys C level of the patients.The general data,laboratory indicators,and cardiac ultrasound results were compared between the 2 groups.Pearson correlation analysis was used to detect the correlation between serum Cys C level and blood lipid level and other factors,and the data related to Cys C were further analyzed by multivariate logistic regression.Results:Compared with the Cys C normal group,patients in the Cys C abnormal group had lower left ventricular ejection fraction(LVEF)(P<0.001),older age(P=0.030),higher incidence rate of diabetes and smoking index(P=0.002 and P=0.003,respectively).The levels of serum creatinine(SCr),blood urea nitrogen(BUN),and total bilirubin(TBIL)were higher(all P<0.001),while the levels of high density lipoprotein(HDL),apolipoprotein(Apo)A,and albumin(ALB)were lower(P<0.001,P=0.001,and P=0.003,respectively)in the Cys C abnormal group.Pearson correlation analysis showed that serum Cys C level was negatively correlated with platelet count,HDL,Apo A,ALB,and LVEF.It was positively correlated with smoking index,mean platelet volume,neutrophil ratio,BUN,and TBIL(all P<0.05).The results of multivariate logistic regression analysis showed that the decreased HDL level was a risk factor for the abnormality of serum Cys C in patients with CHF(OR=0.119,P=0.003),whi

关 键 词：慢性心力衰竭 半胱氨酸蛋白酶抑制剂C 高密度脂蛋白 血脂 载脂蛋白A 

分 类 号：R541.6[医药卫生—心血管疾病]