河北医科大学学报

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血清胱抑素C与慢性心力衰竭近期预后的相关性研究

  

  1. 1.河北医科大学第二医院心血管内三科,河北 石家庄 050000;2.河北省藁城市人民医院心内科,河北 藁城 052160
  • 出版日期:2016-12-25 发布日期:2016-12-29
  • 作者简介:祖秀光(1963-),女,河北石家庄人,河北医科大学第二医院主任医师,医学硕士,从事心血管疾病诊治研究。

Studies on the correlation between cystatin C level and chronic heart failure in diagnosing and shortterm prognosis

  1. 1.Department Ⅲ of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China;
    2.Department of Cardiology, the People′s Hospital of Gaocheng City, Hebei Province, Gaocheng 052160, China
  • Online:2016-12-25 Published:2016-12-29

摘要: [摘要] 目的 探讨血清胱抑素 C ( cystatinC , CysC )与慢性心力衰竭严重程度及近期预后的相关性。方法 纳
入慢性心力衰竭患者 138 例为心力衰竭组,健康体检者 50 例为对照组;检测 2 组治疗前后 N 末端 B 型利钠肽原
( N-terminalpro-B-typenatriureticpeptide , NT-proBNP )、 CysC 、肌酐、尿素、尿酸、左心室射血分数(
leftventricular
ejectionfraction , LVEF )等指标;随访心力衰竭组 6 个月内死亡、心力衰竭再入院及主要心血管事件(心力衰竭加
重、急性冠状动脉综合征、恶性心律失常)发生情况。结果 心力衰竭组 NT-proBNP 、 CysC 水平明显高于对照组,且
随心功能 NYHA 级别升高明显升高;心力衰竭组 LVEF 明显低于对照组,且随心功能 NYHA 级别升高逐渐降低。
随着心功能改善,治疗后 NT-proBNP 、 CysC 、 UA 较治疗前显著降低, LVEF 较治疗前升高。随访 6 个月终点事件
发生组 NT-proBNP 、 CysC 、肌酐、尿酸明显高于未发生组, LVEF 明显低于未发生组。 Logistic 回归显示高 CysC 、
高 NT-proBNP 及低 LVEF 为慢性心力衰竭患者近期终点事件发生的危险因素。结论 血清 CysC 、血浆 NT-
proBNP 及 LVEF 水平可反映慢性心力衰竭患者严重程度。 LVEF 、血清 CysC 及血浆
NT-proBNP 水平与慢性心
力衰竭患者近期预后密切相关,血清 CysC 可作为评估慢性心力衰竭患者近期预后的重要指标之一

关键词: 心力衰竭, 血清胱抑素C, 预后

Abstract: Abstract ] Objective ToinvestigatetherelationshipbetweencystatinC ( CysC ) leveland
chronicheartfailure ( CHF ) indiagnosingandshort-termprognosis.Methods Onehundredand
thirty-eightpatientswithCHFwerechoosedastheCHFgroup , 50caseshealthypeoplewere
choosedasthecontrolgroup.N-terminalpro-B-typenatriureticpeptide ( NT-proBNP ), CysC ,
serumcreatinine ( SCr ), urea , uricacid ( UA ), leftventricularejectionfraction ( LVEF ) were
measuredinthecontrolgroupandtheCHFgroupbeforeandaftertreatment.TheCHFgroup
wasfollowedupfor6monthstorecordall-causemortality , rehospitalizationforCHFandmajor
cardiovascularevents ( heartfailure , acutecoronary syndrome , arrhythmia associated with
hemodynamicdisorder ) .Results ThelevelsofNT-proBNPandCysCoftheCHFgroupwere
significantlyhigherthanthatofthecontrolgroup , andthevaluesweregraduallyincreasedwith
theworseningofheartfunction.ThelevelofLVEFoftheCHFgroupwassignificantlylower
thanthatofthecontrolgroup , andLVEFvaluewasgraduallyreducedwiththeworseningof
heartfunction.NT-proBNP , CysCandUAbeforetreatmentweresignificantlyhigherthanthat aftertreatment , LVEF beforetreatmentwaslowerthanthataftertreatment.NT-proBNP ,
CysC , ScrandUAoftheeventgroupwerehigherthanthatofthenongroup , LVEFoftheevent
groupwassignificantlylowerthanthatofthenongroup.Logisticanalysisshowedthathighlevel
ofCysC , highlevelofNT-proBNPandlowlevelofLVEF wereindependentriskfactorsfor
recentcardiovascularadverseevents.Conclusion ThelevelofCysC , NT-proBNPandLVEFare
closelyrelatedtoCHF , theycanreflecttheseverityofcardiacfunction.ThelevelofLVEF ,
CysCandNT-proBNParecloselyrelatedtotheshort-termprogn

Key words: heart failure, cystatin C, prognosis