CypA,BNP,ET-1浓度在老年慢性心衰患者中的表达及临床意义

目的 探讨环亲素A(CypA)、脑钠肽(BNP)、内皮素-1(ET-1)在老年慢性心衰患者中的表达特征及临床意义。方法 选取湖北省天门市第一人民医院在2015年6月～2016年6月收治的56例老年慢性心衰患者作为研究组,另选取同期在该院进行健康体检的46例健康老年人作为对照组,研究对象均经心电图等相关检查确诊,并排除并发风湿免疫性疾病者、伴有先天性心脏病者、伴有血液疾病者、近期有感染病史者、凝血功能障碍者、并发恶性肿瘤者。运用ELISA法进行BNP,CypA和ET-1检测,运用乳胶免疫比浊法进行超敏C反应蛋白(hs-CRP)检测,采用t检验或F检验对比、分析检测结果。结果 研究组患者的BNP,CypA,hs-CRP和ET-1水平分别为368.42±67.05 ng/L,5.47±2.11 ng/L,18.32±2.33 mg/L和110.62±33.62 mg/L,对照组分别为159.40±57.42 ng/L,2.89±0.36 ng/L,8.40±1.16 mg/L和65.55±27.63 mg/L,研究组的BNP,CypA,hs-CRP,ET-1水平均显著高于对照组(t=16.700,8.189,26.306,7.290,P<0.05)。NYHA分级Ⅰ级患者的BNP,CypA,hs-CRP,ET-1水平分别为210.6±48.39 ng/L,68.66±12.87 ng/L,10.71±2.60 mg/L和87.21±12.41 mg/L; Ⅱ级患者分别为234.83±54.31 ng/L,73.13±16.48 ng/L,11.68±2.25 mg/L和92.32±13.32 mg/L; Ⅲ级患者分别为313.13±66.42 ng/L,96.82±18.47 ng/L,16.68±2.02 mg/L和113.54±21.85 mg/L; Ⅳ级患者分别为395.50±69.47 ng/L,111.13±19.43 ng/L,19.25±3.57 mg/L和127.36±18.73 mg/L。研究组不同NYHA心功能分级患者的BNP,CypA,hs-CRP,ET-1水平比较,差异均有统计学显著性意义(F=8.36,7.98,8.55,8.93,均P<0.05)。研究组血清BNP与CypA呈正相关关系(r=0.49),hs-CRP与CypA呈正相关关系(r=0.57),hs-CRP与BNP呈正相关关系(r=0.77),CypA与ET-1的表达呈正相关关系(r=0.53,P<0.05)。结论 老年慢性心衰患者的血清BNP,CypA,ET-1表达明显上调,检测BNP,CypA,ET-1可为临床评估病变程度提供可靠依据。

Expression Characteristics and Clinical Significance of CypA,BNP and ET-1 in Elderly Patients with Chronic Heart Failure

Objective To investigate the expression characteristics and clinical significance of CypA,BNP and ET-1(Endothelin-1)in elderly patients with chronic heart failure.Methods 56 cases of elderly patients with chronic heart failure in Hubei Tianmen First People's Hospital as study group,selected another 46 cases of healthy elderly peoplein the same period as control group.Research objects were diagnosed by the relevant electrocardiogram and exclude merger rheumatic autoimmune diseases,associated with congenital heart disease,blood diseases associated with the recent history of infection,coagulation disorders,combinedmalignancy.Used ELISA methodexamine BNP,CypA and ET-1,used latex turbidimetric immunoassay to examine hs-CRP(high-sensitivity C-reactive protein),and used t-test or F-test comparison analysed test results.Results The BNP,CypA,hs-CRP and ET-1 levels of study group were 368.42±67.05 ng/L,5.47±2.11 ng/L,18.32±2.33 mg/L and 110.62±33.62 mg/L.Control group were 159.40±57.42 ng/L,2.89±0.36 ng/L,8.40±1.16 mg/L and 65.55±27.63 mg/L.TheBNP,CypA,hs-CRP and ET-1 levels of study group were significantly higher than control group(t=16.700,8.189,26.306,7.290,P<0.05).The BNP,CypA,hs-CRP and ET-1 levels of NYHA classification grade Ⅰ patients were 210.6±48.39 ng/L,68.66±12.87 ng/L,10.71±2.60 mg/L and 87.21±12.41 mg/L.NYHA classification grade Ⅱ patients were 234.83±54.31 ng/L,73.13±16.48 ng/L,11.68±2.25 mg/L and 92.32±13.32 mg/L.NYHA classification grade Ⅲ patients were 313.13±66.42 ng/L,96.82±18.47 ng/L,16.68±2.02 mg/L and 113.54±21.85 mg/L,NYHA classification grade Ⅳ patients were 395.50±69.47 ng/L,111.13±19.43 ng/L,19.25±3.57 mg/L and 127.36±18.73 mg/L.The BNP,CypA,hs-CRP and ET-1 levels of different NYHA class patients compared,there were significant differences(F=8.36,7.98,8.55,8.93,all P<0.05).Serum BNP in study group with CypA showed a positively relationship(r=0.49),hs-CRP with CypA showed a positively relationship(r=0.57),hs-CRP with BNP showed a positively relationship(r=0.77),CypA withET-1 showed a positively relationship(r=0.53,P<0.05).Conclusion Serum BNP,CypA and ET-1 in elderly patients with chronic heart failure was significantly upregulated,and detecting BNP,CypA and ET-1 able to assess the clinical severity provide a reliable basis.