2型心肾综合征患者血清CysC及血浆Hcy水平变化及意义

目的探讨胱抑素C(CysC)、同型半胱氨酸(Hcy)在2型心肾综合征患者体内水平变化及意义。方法回顾性分析2018年6-12月在我院就诊的心力衰竭患者,根据是否合并肾功能异常分为单纯心力衰竭组(50例)及心肾综合征组(50例),本研究肾功能异常定义为肾小球滤过率(GFR)<60mL/min,另选取30例在我院健康体检正常的人群作为健康对照组。观察不同组别,不同心功能患者的CysC、Hcy、左室射血分数(LVEF)等指标的水平变化。结果心肾综合征组及单纯心力衰竭组患者血清CysC、血浆Hcy水平高于健康对照组(P<0.05);心肾综合征组患者血清CysC、血浆Hcy水平高于单纯心力衰竭组的患者(P<0.05);心肾综合征患者随着心功能分级的增高,血清CysC及血浆Hcy水平逐渐升高(P<0.05);心肾综合征患者血清CysC及血浆Hcy水平变化与LVEF水平变化呈负相关(P<0.05);ROC曲线表明CysC及Hcy对诊断心肾综合征有意义(AUC分别为0.610、0.707,95%CI分别为0.500~0.652、0.596~0.812,P=0.001)。结论血清CysC及血浆Hcy水平有助于2型心肾综合征诊断,且在一定程度上能够反映疾病的严重程度。

Changes in serum cystatin C and plasma homocysteine in patients with type 2 cardiorenal syndrome and their clinical significance

Objective To investigate the changes in serum cystatin C(CysC) and plasma homocysteine(Hcy) in patients with type 2 cardiorenal syndrome and their clinical significance. Methods A retrospective analysis was performed for the clinical data of the patients with heart failure who attended our hospital from June to December, 2018,and according to the presence or absence of abnormal renal function, they were divided into heart failure group with 50 patients and cardiorenal syndrome group with 50 patients. Abnormal renal function in this study was defined as glomerular filtration rate <60 mL/min. A total of 30 healthy individuals who underwent physical examination in our hospital were enrolled as healthy control group. The changes in the indices including CysC, Hcy, and left ventricular ejection fraction(LVEF) were observed and compared between groups and patients with different conditions of cardiac function. Results The cardiorenal syndrome group and the heart failure group had significantly higher serum CysC and plasma Hcy than the healthy control group(P <0.05). The cardiorenal syndrome group had significantly higher serum CysC and plasma Hcy than the heart failure group(P <0.05). In the patients with cardiorenal syndrome, serum CysC and plasma Hcy increased with the increase in cardiac functional grading(P<0.05) and were negatively correlated with LVEF(P<0.05). The receiver operating characteristic(ROC) curve showed that CysC and Hcy had certain value in the diagnosis of cardiorenal syndrome, with an area under the ROC curve of 0.610(95% confidence interval CI]: 0.500-0.652) and0.707(95% CI: 0.596-0.812), respectively(P =0.001). Conclusion Serum CysC and plasma Hcy may help with the diagnosis of type 2 cardiorenal syndrome and can reflect disease severity to some extent.