CysC与NT-proBNP水平在慢性心力衰竭中的变化及意义

目的观察慢性心力衰竭（chronic heart failure,CHF）患者血清胱抑素C（Cystatin C,CysC）以及N端脑钠肽前体（N-Terminal pro-brain natriuretic peptide,NT-proBNP）水平的变化,并探讨其临床意义。方法将57例CHF患者按照美国纽约心脏病学会心功能分级标准（New York Heart Association,NYHA）进行分级,分为Ⅱ、Ⅲ、Ⅳ级。选取健康对照组51例。分别测定血清CysC、血浆NT-proBNP水平以及左室射血分数（left ventricularejection fraction,LVEF）,并进行相关性分析。结果 CHF组血清CysC以及血浆NT-proBNP水平高于健康对照组（P〈0.01）,并且CHF组内随着CHF程度的加重,CysC以及NT-proBNP的水平也升高。相关性分析发现,CHF组血清CysC与LVEF呈中等负相关（r=-0.793,P〈0.01）,CHF组血浆NT-proBNP与LVEF呈中等负相关（r=-0.618,P〈0.01）,CHF组血清CysC与血浆NT-proBNP呈中等正相关（r=0.742,P〈0.01）。结论血清CysC以及血浆NT-proBNP与心力衰竭密切相关,可以反映CHF的心功能,有利于临床上对心力衰竭的早期诊断和治疗。

Changes of CysC and NT-proBNP in patients with chronic heart failure and their clinical significance

Objective To observe changes of concentrations of cystatin C and NT-proBNP levels in patients with heart failure and evaluate the clinical significance of cystatin C and NT-proBNP levels.Methods Serum cystatin C levels,plasma NT-proBNP levels and LVEF were measured in 57 patients with heart failure in New York Heart Association（NYHA）class Ⅱto Ⅳ,these were compared with 51 control subjects without heart failure.Results cystatin C and NT-proBNP levels were higher in patients with heart failure than control subjects（P0.01）,and increased follow heart failure progress.Cystatin C and NT-proBNP levels were negatively related to LVEF.Serum levels of cystatin C were positively related to plasma levels of NT-proBNP.Conclusion cystatin C and NT-proBNP levels can reflect the state of cardiac function,and could become useful tools in facilitating early diagnosis and adequate treatment.