血清可溶性细胞间黏附分子-1、C反应蛋白与B型钠尿肽水平检测在充血性心力衰竭病情评估中的临床价值

Clinical value of serum levels of soluble intercellular adhesion molecule-1 and C-reactive protein and B-type natriuretic pepllde in patients with congestive heart failure

目的探讨血清可溶性细胞间黏附分子-1（sICAM-1）、C反应蛋白（CAP）与B型钠尿肽（BNP）水平检测在充血性心力衰竭病情评估中的应用价值。方法选择63例充血性心力衰竭患者，比较不同NYHA心功能分级以及治疗前后血清sICAM-1、BNP与CRP水平的变化。结果NYHA心功能分级≥Ⅲ级患者血清sICAM-1、BNP与CRP水平显著高于NYHA心功能分级〈Ⅲ级患者[（392．6±73．3）μg／L比（212．6±83．4）pg／L，（1992．5±1173．7）ng/L比（512．6±283．2）ng／L，（49．3±33．5）mg／L比（6．1±3．6）mg／L]，差异有统计学意义（P〈0．01）。63例患者治疗后血清sICAM．1、BNP与CRP水平较治疗前显著降低[（168．94±52．5）μg/L比（362．8±123．1）μg，L，（68．6±38．4）ng／L比（1470．9±1460．1）ng／L，（3．6±2．8）mg／L比（34．1±29．8）mg／L]，差异有统计学意义（P〈0．01）。结论血清sICAM．1、BNP与CRP水平和充血性心力衰竭患者病情严重程度存在相关性，可作为评估治疗效果和判断预后的指标。

Objective To study the value of serum soluble intercellular adhesion molecule-1 （sICAM-1）, B-type natriuretic peptide （BNP） and C-reactive protein （CRP） levels detection on assessment of illness in patients with congestive heart failure. Methods Sixty-three patients with congestive heart failure were involved in this study. The levels of serum sICAM-1, BNP and CRP were compared in patients with different NYHA cardiac function classification before and after treatment. Results The levels of serumsICAM-1, BNP and CRP in NYHA cardiac function classiScation ≥Ⅲ gracle patients were significantly higher than those in NYHA cardiac function classification 〈 Ⅲ grade patients [ （392.6 ±73.3 ）μ g/L vs. （212.6 ± 83.4） μg/L, （ 1992.5 ±173.7） ng/L vs.（512.6 ± 283.2） ng/L, （49.3± 33.5） mg/L vs.（6.1±3.6） mg/L] （P 〈 0.01 ）. The levels of serum sICAM-1, BNP and CRP after treatment were significantly decreasedcompared with those before treatment [ （ 168.9±52.5 ）μ g/L vs.（362.8 ±123.1 ）μg/L, （68.6 ± 38.4） ng/L vs.（1470.9± 1460.1） ng/L, （3.6 ±2.8） mg/L vs. （34.1 ±29.8） mg/L]（P〈0.01）. Conclusion Serum sICAM-1 ,BNP and CRP levels are positively related with illness,and serum sICAM-1 ,BNP and CRP levels may be judged as an index assessing treatment effect and prognosis.