老年心力衰竭患者N末端B型利钠肽原与血清半胱氨酸蛋白酶抑制素C水平变化的临床意义
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Clinical application of N-terminal pro-B-type natriuretic peptide and Cystatin C for elderly patients with chronic heart failure
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    摘要:

    目的:探讨血清中N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)与胱抑素C(cystatin C,Cys-C)水平变化在诊断老年慢性心力衰竭(chronic heart failure,CHF)患者以及评估心功能及预后的价值。方法:选取老年CHF患者178例作为观察组,按纽约心脏病协会 (New York Heart Association,NYHA)心功能分级Ⅰ级35例,Ⅱ级47例,Ⅲ级64例,Ⅳ级32例,另选取健康体检者87例作为健康对照组,测定NT-proBNP与Cys-C水平,以及左室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)及左室射血分数(left ventricular ejection fraction,LVEF),比较老年CHF患者与健康对照组-不同心功能分级CHF患者间NT-proBNP与Cys-C水平的差异;采用Logistic回归分析老年CHF患者死亡终点事件影响因素,采用Spearman相关统计NT-proBNP-Cys-C与LVEDD-LVEF的相关性。结果:观察组NT-proBNP-Cys-C-LVEDD高于健康对照组,LVEF低于健康对照组(P < 0.05);心功能分级Ⅰ~Ⅵ级患者NT-proBNP-Cys-C-LVEDD逐级升高,LVEF值逐级降低,各级之间差异均有统计学意义(P < 0.05)。Logistic回归分析显示NT-proBNP-Cys-C-LVEF是老年CHF患者死亡事件的危险因素(P < 0.05)。相关分析显示,观察组患者中,NT-proBNP与LVEDD呈正相关(r=0.824,P < 0.05),与LVEF呈负相关(r=-0.723,P < 0.05),Cys-C与LVEDD呈正相关(r=0.797,P < 0.05),与LVEF呈负相关(r=-0.714,P < 0.05)。结论:NT-proBNP与Cys-C水平有助于诊断老年CHF并对患者心功能程度进行分级,对于老年CHF患者的预后有预测意义。

    Abstract:

    Objective:To observe the clinical significance of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and Cystatin C (Cys-C) in diagnosing elderly patients with chronic heart failure (CHF) and evaluating classification of cardiac function and prognosis. Methods: A total of 178 elderly patients with CHF were selected as the observation group, including 35 cases of cardiac function grade Ⅰ, 47 cases of gradeⅡ, 64 cases of grade Ⅲ, 32 cases of grade Ⅳ according to New York Heart Association Functional Classification (NYHA), and 87 healthy people taking health examination were selected as the healthy control group. NT-proBNP and Cys-C levels were detected, and left ventricular end-diastolic diameter (LVEDD), 1eft ventricular ejection fraction (LVEF) were measured. NT-proBNP and Cys-C levels were compared between the observation group and the healthy control group, and between patients with different cardiac function grades. Logistic regression analysis was performed to analyze the influencing factors of death end events in elderly patients with CHF, and the correlation among NT-proBNP, Cys-C and LVEDD, LVEF was analyzed by using Spearman correlation statistics. Results: NT-proBNP level, Cys-C level and LVEDD in the observation group were higher than those in the healthy control group, LVEF in the observation group was lower than that in the healthy control group (P < 0.05). NT-proBNP, Cys-C, and LVEDD were gradually increased from cardiac function grade Ⅰ to grade Ⅳ, while LVEF was gradually decreased (P < 0.05). Logistic regression analysis showed that NT-proBNP, Cys-C, and LVEF were risk factors of death of elderly CHF patients (P < 0.05). Correlation analysis showed that NT-proBNP was positively correlated with LVEDD (r=0.824, P < 0.05), while negatively correlated with LVEF (r=-0.723, P < 0.05), Cys-C was positively correlated with LVEDD (r=0.797, P < 0.05), while negatively correlated with LVEF (r=-0.714, P < 0.05). Conclusion: NT-proBNP and Cys-C level are useful in diagnosing elderly CHF patients and evaluating classification of cardiac function, and have certain predictive value for prognosis of elderly CHF patients.

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谢 岩,任志文,王月香,席 燕,刘红阳,唐 燕.老年心力衰竭患者N末端B型利钠肽原与血清半胱氨酸蛋白酶抑制素C水平变化的临床意义[J].南京医科大学学报(自然科学版),2016,(7):817-820

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  • 收稿日期:2015-08-02
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  • 在线发布日期: 2016-07-15
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