微量白蛋白尿与慢性心力衰竭的关系

Correlation of microalbuminuria and chronic heart failure

目的探讨微量白蛋白尿（microalbuminuria，MAU）与慢性心力衰竭之间的关系。方法选择98例慢性心力衰竭患者，按照纽约心脏协会（New York Heart Association，NYHA）心功能分级标准分为心功能代偿组（NYHAⅠ级）、心功能失代偿组（NYHAⅡ-Ⅳ级）。选择同期正常体检者共52名作为对照组。测定并比较3组肌酐、肾小球滤过率（GFR）、尿白蛋白肌酐比（urinary albumin／creatinine ratio，UACR）、MAU、脑钠肽（BNP）、左心室射血分数（LVEF）、左心室舒张末内经（LEVDd）水平。结果心功能失代偿组（NYHAⅡ-Ⅳ级）患者UACR明显增高，各组间比较差异均有统计学意义（P〈0．01）；心功能失代偿组MAU较其他两组明显升高，差异有统计学意义（P〈0．01）：心功能代偿组与对照组比上述指标比较，差异无统计学意义（P〉0．05）。结论MAU浓度与心功能分级有关，可以用于临床评估心力衰竭的严重程度。

Objectives To investigate the relationship between microalbuminuria （MAU） and chronic heart failure （CHF）. Methods Totally 98 patients with CHF were divided into cardiac compensation group [New York Heart Association （NYHA） class Ⅰ ] and cardiac decompensation group （NYHA class Ⅱ -Ⅳ ） according to NYHA standards. A total of 52 cases with normal physical examination were selected as control group at the same period. Glomerular filtration rate （GFR）, urinary albumin/creatinine ratio （UACR）, MAU, brain natriuretic peptide （BNP）, left ventricular ejection fraction （LVEF） and left ventricular end-diastolic dimension （LEVDd） were measured and compared among the three groups. Results UACR and MAU in cardiac decompensation group （NYHA class Ⅱ-Ⅳ ） were significantly higher than those in the other two groups, and the differences were statistically significant （P〈0.01）. However, UACR and MAU had no statistically significant differences between cardiac compensation group and control group （P〉0.05）. Conclusions MAU correlates with cardiac functional classification, which can be used to evaluate the severity of heart failure.