血清Hcy、NT-ProBNP、25-(OH)D3水平与老年慢性心力衰竭患者左心功能的关系及对预后的评估价值  

Relationship Between Serum Hcy,NT-ProBNP,25-(OH)D3 Levels and Left Heart Function in Elderly Patients with Chronic Heart Failure and Their Prognostic Value

作　　者：胡华丽[1] 杨玲玲[1] 栗春香 HU Hua-li;YANG Ling-ling;LI Chun-xiang(Department of Medical Laboratory,Pingyu People's Hospital,Pingyu,Henan,463400,China;Department of Hematology,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou,Henan,450000,China)

机构地区：[1]河南省平舆县人民医院医学检验科,河南平舆463400 [2]河南省儿童医院,郑州儿童医院血液病研究室,河南郑州450000

出　　处：《中国血液流变学杂志》2023年第3期429-433,共5页Chinese Journal of Hemorheology

摘　　要：目的探讨血清同型半胱氨酸(Hcy)、N端脑钠肽前体(NT-ProBNP)、25羟维生素D3(25-(OH)D3)水平与老年慢性心力衰竭(CHF)患者左心功能的关系及对预后的评估价值。方法选取2021年5月—2022年8月平舆县人民医院老年CHF患者150例,并根据治疗后恢复情况分为预后优良组65例和预后一般组85例。比较两组治疗前后血清Hcy、NT-ProBNP、25-(OH)D3水平及入院时心功能指标[纽约心功能(NYHA)分级、左心室舒张功能障碍、左室射血分数(LVEF)];分析入院时血清Hcy、NT-ProBNP、25-(OH)D3水平与NYHA分级、左心室舒张功能障碍、LVEF的相关性及联合检测预后恢复的预测价值。结果预后优良组血清Hcy、NT-ProBNP水平低于预后一般组,血清25-(OH)D3水平高于预后一般组(P<0.05);不同心功能指标老年CHF患者血清Hcy、NT-ProBNP、25-(OH)D3水平比较,差异具有统计学意义(P<0.05);入院时血清Hcy、NT-ProBNP、25-(OH)D3水平与NYHA分级、左心室舒张功能障碍呈正相关(P<0.001);血清Hcy、NT-ProBNP水平与LVEF呈负相关,血清25-(OH)D3水平与LVEF呈正相关(P<0.001);入院时血清Hcy、NT-ProBNP、25-(OH)D3水平联合诊断老年CHF的AUC大于各单独指标诊断(P<0.05)。结论血清Hcy、NT-ProBNP、25-(OH)D3水平与老年CHF患者左心功能密切相关,其联合水平检测具有预测患者预后情况的重要意义。Objective To investigate the relationship between serum homocysteine(Hcy),NT-ProBNP,25 hydroxyvitamin D3(25-(OH)D3)levels and left heart function in elderly patients with chronic heart failure(CHF)and the value of prognosis evaluation.Methods 150 elderly CHF patients in Pingyu People's Hospital from May 2021 to August 2022 were selected and divided into 65 patients with good prognosis group and 85 patients with general prognosis group according to their recovery after treatment.The levels of serum Hcy,NT-ProBNP and 25-(OH)D3 before and after treatment were compared between the two groups,as well as the cardiac function indicators at admission[New York Cardiac Function(NYHA)grade,left ventricular diastolic dysfunction,left ventricular ejection fraction(LVEF)].The correlation of serum Hcy,NT-ProBNP,25-(OH)D3 levels with NYHA grade,left ventricular diastolic dysfunction and LVEF and the predictive value of combined detection for prognosis recovery were analyzed.Results The serum Hcy and NT-ProBNP levels in the good prognosis group were lower than those in the general prognosis group,and the serum 25-(OH)D3 levels were higher than those in the general prognosis group(P<0.05).The levels of serum Hcy,NT-ProBNP and 25-(OH)D3 in elderly CHF patients with different cardiac function indexes had statistical significance(P<0.05).Serum Hcy,NT-ProBNP,25-(OH)D3 levels were positively correlated with NYHA grade and left ventricular diastolic dysfunction at admission(P<0.001).Serum Hcy and NT-ProBNP levels were negatively correlated with LVEF,and serum 25-(OH)D3 levels were positively correlated with LVEF(P<0.001).The AUC of serum Hcy,NT-ProBNP and 25-(OH)D3 in the combined diagnosis of CHF in the elderly was higher than that of each single index(P<0.05).Conclusion Serum Hcy,NT-ProBNP,25-(OH)D3 levels are closely related to left heart function in elderly patients with CHF,and their combined level detection has important significance in predicting the prognosis of patients.

关 键 词：老年慢性心力衰竭 同型半胱氨酸 N端脑钠肽前体 25羟维生素D3 预后 

分 类 号：R446.11[医药卫生—诊断学] R541.6[医药卫生—临床医学]