高敏C反应蛋白和血浆N末端原脑钠肽对老年心力衰竭患者预后的影响

Study on relationship between changes of hs-CRP and N-terminal pro-brain natriuretic peptide and prognosis in elderly patients with congestive heart failure

目的探讨高敏C反应蛋白(hs-CRP)和血浆N末端原脑钠肽(NT-proBNP)对老年慢性心力衰竭住院患者预后的影响。方法选择60例慢性心力衰竭的老年人,按照NYHA分级,分为心功能Ⅱ、Ⅲ、Ⅳ级三个亚组,分别测定hs-CRP和NT-proBNP,比较组间的hs-CRP和NT-proBNP变化。再根据住院期间心血管事件发生(急性冠脉综合征、心力衰竭反复加重、死亡)与否,分为心血管事件组和非心血管事件组。比较组间的hs-CRP和NTproBNP的变化。结果心功能Ⅳ、Ⅲ级患者与心功能Ⅱ级患者比较hs-CRP明显升高(P<0.05),NT-proBNP明显升高(P<0.05)。心血管事件组和非心血管事件组比较,心血管事件组的hs-CRP和NT-proBNP高于非心血管事件组(P<0.05)。结论 hs-CRP和NT-proBNP影响老年慢性心力衰竭住院患者的预后,随着心功能级别的加重,免疫炎症反应加剧,心血管事件也在增加。

Objective To explore the effect of serum levels of hs- CRP and N- terminal pro- brain natriuretic peptide on the prognosis of elderly patients with congestive heart failure. Methods A total of 60 elderly patients with heart failure were divided into 2 groups according to the criteria for grades of cardiac function of New York Heart Association（ NYHA）. The levels of hs- CRPand NT- pro BNP and cardiac events in elderly patients with chronic heart failure were compared. Results The levels of hs- CRP were significantly elevated in patients of NY Ⅳ group and NY Ⅲ group than patients of NYⅡgroup（P〈0. 05）. Levels of NT- pro BNP were significantly elevated in patients of NYⅣgroup and NYⅢ group than those of patients in NYⅡgroup（P〈0. 05）. The levels of hs- CRP and NT- pro BNP were much higher in patients with cardiac events than those without cardiac events. Conclusion The detection of serum levels of hs- CRP and NT- pro BNP has clinical significance in evaluation of the prognosis of elderly patients with chronic heart failure.