不同NYHA分级老年CHF患者血清cTnⅠ、Cys C及UA水平变化及临床意义  

Changes and Clinical Significance of Serum CTnI,Cys C and UA Levels in Elderly CHF Patients with Different NYHA Grades

作　　者：徐静[1] 王燕青[1] 周楠 王洁 XU Jing;WANG Yanqing;ZHOU Nan;WANG Jie(Department of Clinical Laboratory,Xuzhou First People's Hospital,Xuzhou,Jiangsu Province,221100 China)

机构地区：[1]徐州市第一人民医院检验科,江苏徐州221100

出　　处：《系统医学》2022年第23期36-39,44,共5页Systems Medicine

摘　　要：目的 探讨纽约心脏病协会(New York Heart Association, NYHA)不同分级的老年慢性心力衰竭(chronic heart failure, CHF)患者血清心肌肌钙蛋白Ⅰ(cTnⅠ)、胱抑素C(Cys C)、尿酸(UA)的水平变化及临床意义。方法选取2020年1月-2022年6月徐州市第一人民医医院收治的151例老年CHF患者作为观察组,根据NYHA分级分为Ⅰ级(29例)、Ⅱ级(44例)、Ⅲ级(53例)、Ⅳ级(25例),另选取同期于本院体检的健康老年人201名作为对照组。比较对照组、观察组及不同NYHA分级患者治疗前后血清cTnⅠ、Cys C、UA水平,并分析血清cTnⅠ、Cys C、UA水平与NYHA分级的相关性。结果 观察组血清cTnⅠ、Cys C、UA水平均高于对照组,差异有统计学意义(P<0.05)。治疗后,不同NYHA分级患者血清cTnⅠ、Cys C、UA水平均降低,其中心功能Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级患者治疗前后的血清Cys C、cTnⅠ、UA水平均依次升高,差异有统计学意义(P<0.05)。血清cTnⅠ、Cys C、UA水平与患者NYHA分级呈正相关关系(r=0.435、0.356、0.437,P<0.05)。结论 老年CHF患者NYHA分级越高,血清cTnⅠ、Cys C、UA水平越高,心脏功能受损越严重,临床医师可通过上述指标水平变化评估老年CHF患者心脏功能,制订针对性治疗方案,从而改善预后。Objective To investigate the changes of cardiac troponin Ⅰ(cTnⅠ),cystatin C(Cys C)and uric acid(UA)levels and their clinical significance in senile patients with chronic heart failure(CHF)classified by New York Heart Association(NYHA).Methods A total of 151 elderly patients with CHF admitted to Xuzhou First People's Medical Hospital from January 2020 to June 2022 were selected as the observation group.According to NYHA classification,the patients were classified into gradeⅠ(29 cases),gradeⅡ(44 cases),gradeⅢ(53 cases),and gradeⅣ(25 cases).In addition,201 healthy elderly people who were examined in our hospital at the same time were selected as the con⁃trol group.Serum levels of cTnI,Cys C and UA in the control group,observation group and patients with different NYHA grades before and after treatment were compared,and the correlation between serum levels of cTnI,Cys C and UA and NYHA grades was analyzed.Results The levels of serum cTnI,Cys C and UA in the observation group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).After treat⁃ment,the levels of serum cTnI,Cys C and UA in patients with different NYHA grades decreased,and the levels of se⁃rum Cys C,cTnI and UA in patients with grade Ⅰ,Ⅱ,Ⅲ and IV central function increased successively before and af⁃ter treatment,with statistically significant difference(P<0.05).Serum levels of cTnI,Cys C and UA were positively cor⁃related with NYHA grading in elderly patients with CHF(r=0.435,0.356,0.437,P<0.05).Conclusion The higher the NYHA grade in elderly CHF patients,the higher the serum cTnI,Cys C and UA levels,and the more severely im⁃paired the heart function.Clinicians can evaluate the heart function of elderly CHF patients through the changes of the above indexes and formulate targeted treatment plans,so as to improve the prognosis.

关 键 词：慢性心力衰竭 纽约心脏病协会分级 心肌肌钙蛋白Ⅰ 胱抑素C 血尿酸 相关性 

分 类 号：R541[医药卫生—心血管疾病]