胱抑素C、嗜铬粒蛋白A在慢性心力衰竭中的作用及相关性

目的：通过检测慢性心力衰竭（CHF）患者血清胱抑素C（CysC）和嗜铬粒蛋白A（CgA）含量的变化,探讨两者之间的相关性及在CHF发生、发展中的作用。方法：选取我院心内科CHF住院患者48例,其中心功能Ⅱ级组15例、Ⅲ级组17例和Ⅳ级组16例。另选正常体检者20例作为正常对照组。观察各组血清CysC和CgA含量变化并进行相关性分析。结果：①与正常对照组比较,CHF患者中CysC（664.85±14.42）μg/L∶（991.19±108.59）μg/L]和CgA（67.55±5.987）ng/ml∶（317.79±160.028）ng/ml]水平明显升高（P均〈0.001）;且心功能Ⅳ级的高于Ⅲ级,Ⅲ级的高于Ⅱ级CysC（1115.5±40.81）μg/L∶（990.12±32.65）μg/L∶（859.8±20.727）μg/L,CgA（522.13±65.958）ng/ml∶（276.88±2.205）ng/ml∶（146.2±3.144）ng/ml,P均〈0.001],②血清CysC和CgA呈正相关（r=0.931,P〈0.001）。结论：慢性心力衰竭患者血清胱抑素C和嗜铬粒蛋白A水平均显著升高,其水平随心功能NYHA分级的加重而升高,且二者呈正相关,可能共同参与了心衰的发生、发展。

Action of cystatin C and chromogranin A in chronic heart failure and their correlation

Objective：To explore the correlation between serum cystatin C（CysC） and chromogranin A（CgA）and their role in development of CHF.Methods：A total of 48 CHF hospitalized patients were enrolled.Among them,there were 15 cases of NYHA cardiac function class Ⅱ,17 cases of class Ⅲ and 16 cases of class Ⅳ,and 20 cases with normal physical examination results were enrolled as normal control group.The levels of serum CysC and CgA were detected by ELISA and correlation analysis was made by Pearson method.Results：①Compared with normal control group,levels of CysC （664.85±14.42） μg/L vs.（991.19±108.59） μg/L] and CgA （67.55±5.987）ng/ml vs.（317.79±160.028）ng/ml] significantly increased in CHF patients（P0.001 both）.The serum CysC and CgA levels in NYHA cardiac function class Ⅳ、Ⅲ、Ⅱ respectively were CysC（1115.5±40.81） μg/L vs.（990.12±32.65） μg/L vs.（859.8±20.727） μg/L,CgA（522.13±65.958） ng/ml vs.（276.88±2.205） ng/ml vs.（146.2±3.144） ng/ml,P0.001 all],and paired comparison approach showed they were significantly different（P0.001 all）;②There is a positive correlation between serum levels of CysC and CgA（r=0.931,P0.001）.Conclusion：Serum levels of cystatin C and chromogranin A significantly increase in patients with chronic heart failure along with the severity degree of NYHA cardiac function classification increases,indicate they may take part in the development of heart failure together.