超敏C反应蛋白对心力衰竭患者的危险分层及预后判断

The roles of hsCRP on risk stratification and prognosis in patients with heart failure

目的探讨血清中超敏C反应蛋白水平(hsCRP)对心力衰竭的危险分层及预后判断。方法测定心力衰竭组(295例)和对照组(94例)患者血清hsCRP水平,并对不同心功能组因心力衰竭30天内再次住院率及心脏性死亡进行对比,结合各组左室射血分数(LVEF)、血清肌酸激酶同工酶(CK-MB)和血浆B型尿钠肽(BNP)的水平,评价其对心力衰竭的危险分层及预后判断的意义。结果心力衰竭组血清hsCRP水平均高于对照组,并随心功能的下降而升高(P<0.05),其水平与原发病无关(P>0.05)。随着hsCRP水平的升高,因心力衰竭30天内再次住院率及心脏性死亡增加(P<0.05),hsCRP水平较高者LVEF低、BNP水平高,与CK-MB水平无关。结论血清hsCRP有助于心力衰竭的危险分层及预后判断。

Objective To evaluate the role of hsCRP level on risk stratification and prognosis in patients with heart failure. Methods The levels of hsCRP were measured in 295 patients with heart failure （the heart failure group） and 94 patients without heart failure （the control group）. The rates of patient readmitted for worsening heart failure in 30 days and the cardiac mortality, and different levels of LVEF, CK-MB and BNP were compared according to the levels of hsCRP between the two groups, and the meaning of hsCRP in risk stratification and prognosis of patients with heart failure were evaluated. Resuits The hsCRP level in the heart failure group was significantly higher than that in the control group and increased with decrease of cardiac function （ P 〈 0.05 ） , however, the level of hsCRP was irrelevant to the primary diseases （ P 〉 0.05 ）. With increasing of hsCRP levels, the rates of patients readmitted in 30 days for worsening heart failure and the cardiac mortality （P 〈 0.05 ） also increased. The level of LVEF was lower and the level of BNP was higher in patents with higher hsCRP level, whereas, the hsCRP level was irrelevant to CK-MB level. Conclusion The hsCRP level increased with decrease of heart function. Those patents with higher level of hsCRP have higher rates of readmission and cardiac mortality. The hsCRP level is helpful for risk stratification and prognosis in patients with heart failure.