胱抑素C、超敏C反应蛋白和B型利钠肽对慢性心力衰竭患者近期预后的分析

目的观察胱抑素C(cystatin C,CysC)、超敏C反应蛋白及血清B型利钠肽(brain natriuretic peptide,BNP)在慢性心力衰竭(chronic heart failure,CHF)患者早期疗效评价中的应用价值。方法选取2018年1月至2018年12月本院收治的260例CHF患者作为CHF组,根据美国纽约心脏病学会(NYHA)分级标准分为Ⅱ级组(n=99)、Ⅲ级组(n=75)与Ⅳ级组(n=86);同时,选取同期55名正常体检者作为对照组,比较各组血清BNP、CysC、Hs-CRP水平及左室射血分数、左室舒张末期内径。出院3个月随访记录主要心脏不良事件发生情况。结果Ⅲ级组和Ⅳ级组血清尿素氮、肌酐、尿酸、BNP、CysC水平及LVEDD均高于对照组,LVEF低于对照组,差异有统计学意义(P<0.05);Ⅳ组血清尿素氮、肌酐、尿酸、BNP、CysC水平及LVEDD均明显高于Ⅱ级组和Ⅲ级组,且LVEF低于Ⅱ级组和Ⅲ级组(P<0.05)。心功能等级越高,血清BNP、CysC、LVEDD水平越高,LVEF越低,比较差异有统计学意义(P<0.05)。Pearson相关性分析显示,BNP水平与尿素氮、肌酐、尿酸、胱抑素C及左室射血分数呈正相关(P<0.05);BNP水平与LVEDD呈负相关(P<0.05)。发生心脏不良事件(major adverse cardiac events,MACE)组血清BNP、CysC、Hs-CRP水平高于未发生心脏不良事件组(P<0.05)。结论血清BNP、CysC、Hs-CRP水平及左室射血分数与慢性心力衰竭的严重程度密切相关,且会增加近期不良预后风险。

Short-term prognostic analysis of cystatin C,hypersensitive C-reactive protein and brain natriuretic peptide in patients with chronic heart failure

Objective To observe the application value of cystatin C(CysC)and hypersensitive C-reactive protein(Hs-CRP)and brain natriuretic peptide(BNP)in short-term prognostic of chronic heart failure(CHF)patients.Methods 260 CHF patients in our hospital from January 2018 to December 2018 were selected as the CHF group,the CHF group were divided intoⅡgroup(n=99),Ⅲgroup(n=75)andⅣgroup(n=86)according to NYHA function,at the same time,55 healthy people with normal physical examination were selected as control group.The serum BNP,CysC,HsCRP and left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)were compared in each group.Major adverse cardiac events were recorded at 3 months follow-up after discharge.Results The levels of serum urea nitrogen,creatinine,uric acid,BNP,CysC,and LVEDD ofⅢgroup andⅣgroup were higher than those of the control group,and LVEF was lower than that of the control group,the difference was statistically significant(P<0.05).The serum urea nitrogen,creatinine,uric acid,BNP,CysC,and LVEDD ofⅣgroup were significantly higher than those in theⅡgroup andⅢgroup,and the LVEF was lower than in theⅡgroup andⅢgroups(P<0.05).With the higher the level of cardiac function,the higher the serum BNP,CysC and LVEDD levels,the LVEF was lower,and the difference between groups was statistically significant(P<0.05).Pearson correlation analysis showed that BNP level was positively correlated with urea nitrogen,creatinine,uric acid,cystatin C,and left ventricular ejection fraction(P<0.05);BNP level was negatively correlated with LVEDD(P<0.05).Serum levels of BNP,CysC,and HsCRP in major adverse cardiac events(MACE)group were higher than those in the group without adverse cardiac events(P<0.05).Conclusion Serum BNP,CysC,Hs-CRP and left ventricular ejection fraction of patients are closely related to the severity of chronic heart failure,and increase the risk of short-term adverse prognosis.