胱抑素C和高敏C反应蛋白与前白蛋白比值评估老年心律失常型心力衰竭预后的价值

目的探讨血清胱抑素C、高敏C反应蛋白(hs-CRP)/前白蛋白比值联合检测评估老年心律失常型心力衰竭(心衰)患者预后的价值。方法选择老年心律失常型心衰患者132例,根据治疗后随访1年生存情况分为存活组114例和死亡组18例,记录一般临床资料,检测N末端B型钠尿肽前体(NT-proBNP)和B型钠尿肽(BNP)水平,比较2组胱抑素C、hs-CRP/前白蛋白比值,采用ROC曲线分析。结果死亡组年龄、收缩压、BNP及NT-proBNP水平明显高于存活组(P<0.05,P<0.01),LVEF明显低于存活组[(40.25±7.14)%vs(47.54±8.21)%,P<0.01]。胱抑素C和hs-CRP/前白蛋白比值与老年心律失常型心衰患者LVEF、NT-proBNP和BNP水平呈正相关(P<0.05,P<0.01)。LVEF、BNP、NT-proBNP、hs-CRP/前白蛋白比值、胱抑素C是死亡危险因素(P<0.05,P<0.01)。胱抑素C联合hs-CRP/前白蛋白比值预测老年心律失常型心衰短期心功能转归及病死率的曲线下面积明显高于胱抑素C、hs-CRP/前白蛋白比值(P<0.05)。结论胱抑素C、hs-CRP/前白蛋白比值是预测老年心律失常型心衰患者预后的敏感指标,三者联合检测可进一步提高短期预后的预测能力。

Value of serum cystatin C,hs-CRP and prealbumin ratio in predicting outcome of elderly arrhythmic HF patients

Objective To study the value of serum cystatin C,hs-CRP and prealbumin ratio in predicting the outcome of elderly arrhythmic heart failure(HF)patients.Methods One hundred and thirty-two elderly arrhythmic HF patients were divided into survival group(n=114)and death group(n=18).Their general clinical data were recorded and their serum NT-proBNP and BNP levels were measured.The serum cystatin C,hs-CRP and prealbumin ratios were compared.The prealbumin ratio in predicting the outcome of elderly arrhythmic HF patients was analyzed by ROC curve analysis.Results The age was significantly older,the SBP and serum levels of BNP and NT-proBNP were significantly higher while the LVEF(40.25±7.14%vs 47.54±8.21%)was significantly lower in death group than in survival group(P<0.05,P<0.01).Spearman correlation analysis showed that the cystatin C,hs-CRP and prealbumin ratio was positively related with the clinical symptoms of elderly arrhythmic HF patients(P<0.05).Multivariate logistic regression analysis displayed that LVEF,serum BNP and NT-proBNP levels,hs-CRP and prealbumin ratio were the risk factors for death in elderly arrhythmic HF patients(P<0.01).ROC curve analysis revealed that the area under ROC curve for cystatin C combined with hs-CRP and prealbumin ratio was significantly larger than that for cystatin C,hs-CRP and prealbumin ratio in predicting the outcome and mortality of elderly arrhythmic HF patients(P<0.05).Conclusion The cystatin C,hs-CRP and prealbumin ratio is a sensitive index for predictiing the outcome of elderly arrhythmia HF patients.