CRP、CK-MB、NT-proBNP、cTnI与慢性心力衰竭患者心功能及主要不良心血管事件的关系  

Relationship between CRP,CK-MB,NT proBNP,cTnI and Cardiac Function and Occurrence of Major Adverse Cardiovascular Events in Patients with Chronic Heart Failure

作　　者：钟达香 肖祖华 李伟东 ZHONG Daxiang;XIAO Zuhua;LI Weidong(Medical Laboratory Department,Shaozhou People's Hospital of Shaoguan City,Shaoguan 512400,China;不详)

机构地区：[1]韶关市韶州人民医院医学检验科,广东韶关512400

出　　处：《中国医学创新》2024年第30期114-118,共5页Medical Innovation of China

基　　金：广东省韶关市卫生健康科研项目(Y24158)。

摘　　要：目的:探究C反应蛋白(CRP)、肌酸激酶同工酶(CK-MB)、N末端脑利钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)与慢性心力衰竭(CHF)患者心功能及主要不良心血管事件(MACE)的关系。方法:选择2021年1月—2023年5月于韶关市韶州人民医院内科住院治疗的100例CHF患者作为观察组,另选取同期于与本院行健康体检的50例健康志愿者作为对照组。比较两组CRP、CK-MB、NT-proBNP、cTnI水平,分析观察组CRP、CK-MB、NT-proBNP、cTnI水平与心功能的关系;绘制受试者操作特征(ROC)曲线分析CRP、CK-MB、NT-proBNP、cTnI水平对CHF患者发生MACE的预测价值。结果:观察组血清CRP、CK-MB、NT-proBNP、cTnI水平均高于对照组,差异均有统计学意义(P<0.05)。观察组中美国纽约心脏病协会(NYHA)心功能分级Ⅲ、Ⅳ级者血清CRP、CK-MB、NT-proBNP、cTnI水平均高于Ⅱ级者,且Ⅳ级者均高于Ⅲ级者,差异均有统计学意义(P<0.05)。NYHA心功能分级与CHF患者血清CRP、CK-MB、NT-proBNP、cTnI水平均呈正相关(r_(s)=0.780,0.655,0.730,0.809,P<0.05)。MACE患者血清CRP、CK-MB、NT-proBNP、cTnI水平均高于非MACE患者,差异均有统计学意义(P<0.05)。血清CRP、NT-proBNP、CK-MB、cTnI联合预测CHF患者发生MACE的曲线下面积为0.909,高于CRP、CK-MB、NT-proBNP、cTnI单独预测的0.875、0.758、0.826、0.812(P<0.05)。结论:CHF患者血清CRP、CK-MB、NT-proBNP、cTnI水平异常升高,且与患者心功能分级呈正相关,检测上述指标可用于预测患者MACE的发生。Objective:To explore the relationship between C reactive protein(CRP),creatine kinase isoenzyme(CK-MB),N-terminal brain natriuretic peptide precursor(NT-proBNP),cardiac troponin I(cTnI)and cardiac function and major adverse cardiovascular events(MACE)in patients with chronic heart failure(CHF).Method:A total of 100 patients with CHF who were hospitalized in the Internal Medicine Department of Shaozhou People's Hospital of Shaoguan City from January 2021 to May 2023 were selected as the observation group,and 50 healthy volunteers who underwent physical examination with the hospital during the same period were selected as the control group.The levels of CRP,CK-MB,NT-proBNP and cTnI were compared between the two groups,and the relationship between the levels of CRP,CK-MB,NT-proBNP and cTnI and cardiac function in the observation group was analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of CRP,CKMB,NT-proBNP and cTnI levels for MACE in CHF patients.Result:The levels of CRP,CK-MB,NT-proBNP and cTnI in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The levels of serum CRP,CK-MB,NT-proBNP and cTnI in New York heart association(NYHA)heart function gradeⅢandⅣpatients were higher than those in gradeⅡpatients,and those in gradeⅣwere higher than those in gradeⅢ,the differences were statistically significant(P<0.05).NYHA heart function grade was positively correlated with serum CRP,CK-MB,NT-proBNP and cTnI levels in CHF patients(r_(s)=0.780,0.655,0.730,0.809,P<0.05).The levels of CRP,CK-MB,NT-proBNP and cTnI in MACE patients were higher than those in non-MACE patients,the differences were statistically significant(P<0.05).The area under the curve of MACE in CHF patients predicted by the combination of serum CRP,NT-proBNP,CK-MB and cTnI was 0.909,which was higher than 0.875,0.758,0.826 and 0.812 predicted by CRP,CK-MB,NT-proBNP and cTnI alone(P<0.05).Conclusion:The levels of serum CRP,CK-MB,NT-proB

关 键 词：慢性心力衰竭 C反应蛋白 肌酸激酶同工酶 N末端脑利钠肽前体 心肌肌钙蛋白Ⅰ 心功能 心血管不良事件 

分 类 号：R541.6[医药卫生—心血管疾病]