高敏C反应蛋白和心肌肌钙蛋白Ⅰ在慢性心力衰竭中的变化及临床意义

CHnical significance of high.sensitivity C-reactive protein and cardiac troponin Ⅰ in patients with chronic heart failure

目的探讨慢性心力衰竭患者高敏C反应蛋白（hs-CRP）和心肌肌钙蛋白Ⅰ（cTnI）水平变化及其意义。方法80例慢性心力衰竭患者（心力衰竭组）按NYHA心功能分级标准分为心功能Ⅲ级（40例）和心功能Ⅳ级（40例）。另选择80例体检健康者作为对照组。监测心力衰竭组治疗前后hs-CRP和cTnI水平的变化，并与对照组进行比较。结果心力衰竭组治疗前hs-CRP和cTnI水平[（11．56±2．72）mg／L、（0．46±0．11）μg/L]较对照组[（2．31±0．56）mg/L、（O．04±0．13）μg／L]明显升高，差异有统计学意义（P〈0．01）；心力衰竭组中心功能Ⅳ级患者hs-CRP和cTnI水平[（13．07±4．31）mg／L、（0．57±0．05）μg/L]较心功能Ⅲ级患者[（10．04±3．12）mg／L、（0．35±0．09）μg／L]明显升高，差异有统计学意义（P〈0．01）。治疗后心功能Ⅲ级和心功能Ⅳ级患者hs-CRP和cTnI水平均较治疗前显著下降（P〈0．01）。结论慢性心力衰竭患者hs-CRP和cTnI水平升高，并且与心功能损害程度相关。hs-CRP和cTnI可能是反映慢性心力衰竭病情变化的有效指标。

Objective To investigate the changes and values of serum high-sensitivity C-reactive protein （hs-CRP） and cardiac troponin Ⅰ （cTnI） in patients with chronic heart failure, Methods Eighty patients with chronic heart failure （heart failure group） were divided into NYHA heart function Ⅲ grade （40 patients） and Ⅳ grade （40 patients）. Eighty healthy people were included in control group. The levels of serum hS-CRP and cTnI were measured and compared. Results Before treatment, the levels of hs-CRP and cTnI in heart failure group [（ 11.56 ± 2.72） mg/L, （0.46 ± 0.11 ） μg/L ] were significantly higher than thosein control group [ （2.31± 0.56） mg/L, （0.04 ± 0.13 ） pμg/L ] （P 〈 0.01 ）. The levels of hs-CRP and cTnI in heart function IV grade patients [ （ 13.07 ± 4.31 ） mg/L, （0.57 ± 0.05 ） μ g/L ] were significantly higher than those in heart function Ⅲ grade patients [（10.04±3.12） mg,/L, （0.35 ±0.09） μg/L] （P〈0.01）. After treatment, the levels of hs-CRP and cTnI in heart function Ⅲgrade and Ⅳ grade patients were significantly decreased compared with those before treatment（P〈 0.01 ）. Conclusions The levels ofhs-CRP and cTnI inchronic heart failure patients are related to the inflammatory activities and myocardial damage, hs-CRP and cTnI may be effective factors to reflect the severity of heart failure.