慢性心力衰竭患者血脂、血浆NT-ProBNP、CTnI和hs-CRP水平测定的临床分析

目的 测定慢性心力衰竭（CHF）患者的血脂、血浆N氨基末端脑钠肽前体（NT-ProBNP）、心肌肌钙蛋白I（CTnI）和高敏C反应蛋白（hs-CRP）水平并进行临床分析。 方法 采用生化法、荧光免疫分析法和放射免疫分析法测定165例CHF患者和60名正常对照者的血脂和血浆NT-ProBNP、CTnI和hs-CRP水平，并进行比较性分析。 结果 165例CHF患者血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平较60名正常对照者明显降低（TC：tⅡ=2.214，P＜0.05；tⅢ=2.873，P＜0.01；tⅣ=3.146；P＜0.01；TG：tⅡ=2.167，P＜0.05；tⅢ=2.863，P＜0.01；tⅣ=3.063，P＜0.01；LDL-C：tⅡ=2.147，P＜0.05；tⅢ=2.056，P＜0.05；tⅣ=2.184，P＜0.05；HDL-C：tⅡ=2.137，P＜0.05；tⅢ=2.256，P＜0.05；tⅣ=3.148，P＜0.01）。在生物标志物的测定中，165例CHF患者的血浆NT-ProBNP、CTnI和hs-CRP水平与正常对照者之间的差异有统计学意义（NT-proBNP：tⅡ=2.096，P＞0.05；tⅢ=2.813，P＜0.01；tⅣ＝4.135，P＜0.001；CTnI：tⅡ=2.736，P＜0.01；tⅢ=2.962，P＜0.01；tⅣ=3.816，P＜0.001；hs-CRP：tⅡ＝2.103，P＜0.05；tⅢ＝2.956，P＜0.01；tⅣ＝4.452，P＜0.001），而且随左心室射血功能（LVEF）的降低而逐步升高。 结论 CHF患者血脂水平（TC、TG、LDL-C和HDL-C）随LVEF的降低而降低，具有血脂代谢紊乱的现象；血浆生物标志物水平（NT-ProBNP、CTnI和hs-CRP）随LVEF的降低而升高。

The clinical analysis of blood lipid and plasma NT-proBNP,CTnI and hs-CRP levels determined in patients with chronic heart failure

Objective To measure the levels of blood lipid and plasma N-terminal pro-brain natriuretic peptide(NT-proBNP), cardiac troponin I(CTnI) and high sensitive C-reaction protein(hs-CRP) in patients with chronic heart failure(CHF), and carry out clinical analysis. Methods The blood lipid and plasma NT-proBNP, CTnI and hs-CRP levels in 165 patients with CHF and 60 controls were analyzed by chemistry, fluorescent immunoassay and radioimmunoassay, and then the results were analyzed and compared. Results The serum TC, TG, LDL-C and HDL-C levels in 165 patients with CHF were significantly lower than those of 60 controls(TC:tⅡ=2.214, P < 0.05; tⅢ=2.873, P < 0.01; tⅣ=3.146; P < 0.01; TG:tⅡ=2.167, P < 0.05; tⅢ=2.863, P < 0.01; tⅣ=3.063, P < 0.01; LDL-C:tⅡ=2.147, P < 0.05; tⅢ=2.056, P < 0.05; tⅣ=2.184, P < 0.05; HDL-C:tⅡ=2.137, P < 0.05; tⅢ=2.256, P < 0.05; tⅣ=3.148, P < 0.01). In biomarkers determining, the plasma NT-proBNP, CTnI and hs-CRP levels in 165 patients with CHF were significantly higher than those of 60 controls(NT-proBNP:tⅡ=2.096, P > 0.05; tⅢ=2.813, P < 0.01; tⅣ=4.135, P < 0.001; CTnI:tⅡ=2.736, P < 0.01; tⅢ=2.962, P < 0.01; tⅣ=3.816, P < 0.01 and hs-CRP:tⅡ=2.103, P < 0.05; tⅢ=2.956, P < 0.01; tⅣ=4.452, P < 0.001), and the plasma three biomarker levels were increased with decreasing left ventricular ejection function(LVEF). Conclusion The blood lipid(TC, TG, LDL-C and HDL-C) levels were decreased with decreasing LVEF and showing abnormal metabolism, but the plasma biomarkers levels were increased with decreasing LVEF.