慢性心力衰竭患者CRT治疗前后心功能与超敏C反应蛋白变化

Changes of heart function and hypersensitive C reactive protein before and after CRT in patients with chronic heart failure

目的观察慢性心力衰竭(CHF)患者行心脏再同步化治疗(CRT)前后心功能、超敏C反应蛋白(hs-CRP)变化及相互关系。方法对本院20例符合CRT置入指征的CHF患者行CRT,并于术后1个月、3个月、6个月行AV/VV优化,分别在术前、术后1个月、3个月、6个月采用胶乳凝集反应法测定hs-CRP水平,心脏彩超测定左室射血分数(LVEF)、左心室舒张末期内径(LVDd)、磁共振血管造影(MRA)、心脏超声测定室间隔及左室后壁收缩达峰时间延迟(SPWMD)等指标。结果 CRT治疗后患者的心脏功能明显好转,术后1个月、6个月心功能NYHA分级平均降低I级;LVEF、LVDd、MRA、SPWMD均逐渐好转(P<0.05),术后hs-CRP指标逐渐下降(P<0.05);NYHA分级与hs-CRP水平的下降具有相关性(r=0.78,P<0.05)。结论 CHF患者行CRT治疗后,心功能可明显改善,hs-CRP与心功能存在负相关性。

Objective To observe the changes of heart function and hypersensitive C reactive protein （ hs-CRP ） and their interrelation in the patients with chronic heart failure （ CHF ） before and after cardiac resynchronization therapy （ CRT ） . Methods CHF patient （ n =20 ） eligible to CRT placement indications were given CRT, and then AV/VV optimization one month, three months and six months after CRT. The level of hs- CRP was detected by using latex agglutination reaction respectively before and one month, three months and six months after CRT. The left ventricular ejection fraction （ LVEF ） , left ventricular end-diastolic inner diameter （ LVDd ） and magnetic resonance angiography （ MRA ） were determined by using cardiac color ultrasound, and septal to posterior wall motion delay （ SPWMD ） was detected by using Bullseye. Results After the treatment with CRT, the heart function was significantly improved in the patients. The heart function grading of NYHA decreased averagely by I grade, and LVEF, LVDd, MRA and SPWMD improved gradually （ P 0.05 ） one month and six months after CRT. The level of hs-CRP decreased gradually （ P 0.05 ） after CRT. There was a correlation between grading of NYHA and decrease of hs-CRP （ r =0.78, P 0.05 ） . Conclusion After CRT and AV/VV optimization, the heart function is significantly improved in CHF patients. There is a correlation between hs-CRP and heart function.