充血性心力衰竭患者血清C反应蛋白水平与预后关系

目的 观察充血性心力衰竭(CHF)患者血清c反应蛋白(CRP)水平与预后关系.方法 选择342例CHF患者和126例健康者,应用酶联免疫法检测血清CRP水平.结果 CHF患者血清CRP为(8.66±4.38)mg/L,健康对照者为(1.12±0.87)mv:L(P<0.01).168例左室射血分数(LVEF)≤35%者,CRP水平为(11.92±4.55)mg/L,174例LVEF>35%者,CRP为(5/88±1.92)mg/L,LVEF值与CRP水平呈负相关(r=-0.502,P<0.01).心功能为Ⅰ、Ⅱ、Ⅲ、Ⅳ级者,其血清CRP分别为(3.92±0.79)mg/L、(5.03±1.55)me/L、(8.94±2.97)mg/L、(12.21±4.43)mg/L,随访6个月.其中血清CRP≥10 mg/L者病死率32.50%(26/83);5 mg/L≤CRP<10 mg/L者,病死率10.48%(11/109);CRP<5 mg/L者病死率2.76%(4/150).结论 CHF患者血清CRP水平升高程度与心力衰竭严重程度相平行,并预示患者预后不良.

Relationship between the level of serum C-reactive protein and prognostic value in patients with congestive heart failure

Objective To determine whether the level of serum C-reactive protein(CLIP) had prognestie val-ue in patients with congestive heart failure(CHF). Methods Serum CRP was measured by enzyme-linked immuno-assay. Results CRP concentration was ( 8.66±4.38 ) mg/L in CHF patients and (1.12±0.87)mg/L in controls( P<0.01). In patients with LVEF ≤35% and > 35%, CRP was ( 11.92±4.55 ) mg/L and ( 5.88±1.92) mg/L( P<0.01 ). In patients with heart function class Ⅰ,Ⅱ,Ⅲ and Ⅳ, CRP was ( 3.92±0.79 ) mg/L, (5.03±1.55 ) mg/L,(8.94±2.97)mg/L, ( 12.21±4.43 ) mg/L, respectively. A negative correlation was observed between serum C RP concentration and LVEF in patients with CHF( r=-0.502,P<0.01 ). According to the concentration of CLIP,83 pa-tients with CRP≥10mg/L had mortality of 32.50% ,109 patients with CRP<10mg/L and ≥5mg/L had mortality of 10.48%,and 150 patients with CRP < 5mg/L had mortality of 2.76%. Conclusion This study shows that serum CRP is increased and has prognostic value in patients with CHF,that the level of CRP is parallel to the severity of CHF.