血清胱抑素C评估先天性心脏病并发肺动脉高压患者预后的临床价值

目的:研究血清胱抑素C评估先天性心脏病(CHD)并发肺动脉高压(PAH)患者预后的临床价值。方法:对59例CHD并发PAH患者进行门诊随访4. 4年,均进行血清胱抑素C检测。根据预后分为死亡组和存活组。使用Logistic回归分析确定成人CHD并发PAH死亡的预测因子。结果:59例患者中12例(20%)死亡。单因素Logistic回归分析显示CHD并发PAH患者死亡率的显著决定因素有血清胱抑素C(OR=1. 637,P 0. 01)、血肌酐(OR=1. 412,P 0. 01)、高敏肌钙蛋白T(hs-cTnT)(OR=4. 030,P 0. 01),6min步行试验(OR=1. 350,P 0. 05)和三尖瓣环运动位移(TAPSE)(OR=1. 397,P 0. 01)。多因素分析显示仅胱抑素C与死亡密切相关(OR=1. 637,P 0. 01)。结论:血清胱抑素C对CHD并发PAH患者的不良预后(死亡)有一定判断价值。

Clinical value of serum cystatin C in evaluating prognosis of patients with congenital heart disease complicated with pulmonary hypertension

Objective: To study the clinical value of serum cystatin C in predicting the prognosis of patients with congenital heart disease(CHD) complicated with pulmonary hypertension (PAH). Methods: Fifty-nine patients with CHD complicated with PAH were enrolled and followed up. Serum cystatin C levels were measured. Patients were divided into death group and survival group according to the prognostic index. Logistic regression analysis was used to determine the predictors of CHD complicated with PAH mortality in adults. Results: The average follow-up time was 4.4 years, and there were 12 deaths (20%). The univariate logistic regression analysis revealed that the significant determinants of PAH-CHD mortality were serum cystatin C (OR 1.637, P<0.01), serum creatinine (OR 1.412, P<0.01), high sensitivity troponin T (hs-cTnT) (OR 4.030, P<0.01), 6-minute walking test (OR 1.350, P<0.05) and tricuspid annular displacement (OR 1.397, P<0.01). The multivariate analysis showed that only cystatin C (OR 1.637, P<0.01) was closely related to death. Conclusion: Serum cystatin C has certain values in judging the adverse prognosis (death) of adult patients with CHD complicated with PAH.