慢性心力衰竭患者胱抑素C的变化及意义

Changes and Significance of Cystatin C in Patients with Chronic Heart Failure

目的:观察慢性心力衰竭(Chronic Heart Failure,CHF)患者血清胱抑素C(Cystatin C)水平变化,探讨其与CHF之间的意义。方法:研究对象包括从2008年9月-2009年8月本院入选的CHF组70例,正常对照组30例,采用双抗夹心ELISA法检测血清Cystatin C含量,CHF患者心力衰竭程度按NYHA法分级,记录住院期间及出院6个月内全因病死率和因慢性心衰发作再入院率。结果:CHF组患者血清Cystatin C含量明显高于对照组,心功能Ⅳ级组血清Cystatin C浓度高于心功能Ⅱ、Ⅲ级组。根据慢性心衰患者血清中位数Cystatin C浓度,分为CystatinC>1.2mg/l组和CystatinC<1.2mg/l组。两组患者住院期间全因死亡率比较中未发现有明显差异;但高血清Cystatin C浓度组患者较低血清Cystatin C浓度组患者在住院期间死亡有增加的趋势。追踪随访6个月,高血清Cys C浓度组患者出院期间全因死亡率、因心衰再住院率有明显高于低浓度组,有统计学意义(P<0.05)。结论:Cystatin C与CHF的发生有密切关系,可以诊断CHF及反映CHF近中期预后一个很有前途的指标。

Objective：To observe changes of serum Cystatin C concentrations in patients with chronic heart failure,and investigate the significance between Cystatin C and CHF.Methods：The subjects were divided into CHF group（n=70）and healthy control group（n=30） in the hospital from September 2008 to August 2009.Serum Cystatin C concentrations were measured by ELISA assay.Severity of CHF Was based on NYHA heart functional classes.The rate of all-case mortality and rehospitalization for chronic heart failure during hospitalization and discharge from hospital within 6 months.Results：Concentration of serum Cystatin C in CHF group was higher than it in healthy control group,Concentration of serum Cystatin C in CHF group of NYHA Ⅳ class was higher than it in CHF group of NYHA Ⅱ、Ⅲ class.According to the median concentration of Cystatin C,patients were divided into 2 groups：higher Cystatin C group（Cystatin C1.2mg/l） and lower Cystatin C group（Cystatin C1.2mg/l）.There was a trend toward more in-hospital deaths in patients with higher Cystatin C level group,but there was no statistical difference between them。During follow-up for 6 months,the rehospitalization for chronic heart failure and All-cause mortality were higher in patients with higher Cystatin C level group than in those with lower Cystatin C level group（P0.05）.Conclusions：There is close relationship between Cystatin C and chronic heart failure.Serum Cystatin C was a potential biomarker in diagnosis and reflect the recent mid-term prognosis of chronic heart failure.