多种生化指标联合检测在心力衰竭诊断及预后评估中的意义

Significance of combined detection of biochemical indexes in diagnosing and predicting the prognosis of heart failure

目的探讨血清心肌肌钙蛋白T(cardiac troponin T,cTnT)、胱抑素C(cystatin C,CysC)和N端B型脑钠肽前体(N-terminal B-type pro-brain natriuretic peptide,NT-ProBNP)联合检测在心力衰竭诊断及预后评估中的作用。方法不同心功能分级心力衰竭患者130例,检测其入院及出院时cTnT、CysC和NT-ProBNP水平,并与30例体检健康者(对照组)进行比较;随访观察心力衰竭患者心脏事件再发生情况。结果 cTnT、CysC和NT-ProBNP水平在不同心功能分级心力衰竭患者组和对照组之间差异均有统计学意义,且心功能越差,cTnT、CysC和NT-ProBNP水平越高(P<0.05);心力衰竭患者治疗前、后上述指标比较差异有统计学意义(P<0.05);出院后发生心脏事件组出院时cTnT、CysC和NTProBNP水平高于未发生心脏事件组(P<0.05)。结论心力衰竭患者cTnT、CysC和NT-ProBNP水平明显升高,三者联合检测对诊断心力衰竭及对预后评估有重要临床意义。

Objective To explore the significance of combined detection of serum cardiac troponin T （cTnT）, cystatin C （CysC） and N-terminal B-type pro-brain natriuretic peptide （NT-ProBNP） in diagnosing and predicting the prognosis of heart failure. Methods A total of 130 heart failure patients with different cardiac functions were detected the levels of cTnT, CysC and NT-ProBNP on admission and on discharge, and compared with another 30 healthy controls. All the patients were followed up the recurrence of cardiac events. Results The levels of cTnT, CysC and NT-ProBNP differed among the patients with different cardiac functions and health controls, and increased with the worsening of cardiac function （P〈0.05）. The cardiac function indexes changed significantly after treatment in patients with heart failure （P〈0.05）. The levels of cTnT, CysC and plasma NT-ProBNP in patients with cardiac events on discharge were higher than those in patients without cardiac events on discharge （P〈0.05）. Conclusions The levels of cTnT, CysC and NT- ProBNP increase significantly in heart failure patients, and the combined detection of them plays an important role in diagnosing and predicting the prognosis of heart failure.