超敏C反应蛋白与冠心病慢性心力衰竭患者预后指标的关系

The relationship between hs-CRP and prognostic indexes for patients with chronic heart failure caused by coronary heart disease

目的:观察超敏C反应蛋白(hs-CRP)与冠心病慢性心力衰竭患者预后指标的关系。方法:回顾性收集年龄50～75岁,氨基末端B型利钠肽前体(NT-proBNP)≥300ng/L的冠心病慢性心力衰竭患者111例,记录NYHA心功能分级、血液学、心脏彩色多普勒超声检查结果。分别以左室射血分数(LVEF)40%、肾小球滤过率(GFR)90ml/min、血红蛋白(Hb)115g/L、NT-proBNP900ng/L为切点将患者分为若亚干组,观察hs-CRP水平的差异。结果:NT-proBNP≥900ng/L亚组患者hs-CRP高于NT-proBNP<900ng/L亚组,差异有统计学意义(P<0.05),合并肾功能不全亚组患者hs-CRP高于未合并肾功能不全亚组患者,差异有统计学意义(P<0.05)。研究中未发现hs-CRP在不同NYHA心功能分级、舒张和收缩功能不全、贫血患者存在差异(P>0.05)。结论:hs-CRP与冠心病慢性心力衰竭患者NT-proBNP、肾功能有关,但作为诊断和预后指标尚待进一步循证医学证据。

Objective：To observe the relationship between hs-CRP and prognostic indexes for patients with chronic heart failure caused by coronary heart disease.Method：Retrospectively collecting clinic data,NYHA heart function grade,hematology and cardiac color Doppler ultrasound results,from 111 case of patients with chronic heart failure caused by coronary heart disease who were 50-70 years old and whose NT-proBNPs were more than 300 ng/L.Observing the difference of patients＇ hs-CRP in groups based on LVEF （40%）,GFR （90 ml/min）,Hb （115 g/L） and NT-proBNP （900 ml/L）.Result：Hs-CRP in group with NT-proBNP ≥900 ng/L is higher than that in group with NT-proBNP 900 ng/L （P〈0.05）.Hs-CRP in group with renal dysfunction is higher than that in group without renal dysfunction.Hs-CRP is not different among in the groups based on NYHA heart function grades,diastolic and contract dysfunction and anaemia （P〈0.05）.Conclusion：Hs-CRP is correlated with NT-proBNP and renal function of patients with chronic heart failure caused by coronary heart disease,which still need to be proved by evidence-based medicine as index for diagnosis and prognosis.