老年高血压合并射血分数保留的心衰患者血浆BNP、同型半胱氨酸、C反应蛋白水平变化的关系及意义

The Correlation and Its Significance of BNP,Homocysteine and C-reactive Protein Level in Elderly Heart Failure Patients with Preserved Ventricular Ejection Fraction and Hypertension

目的观察HF-PEF患者血浆BNP、HCY、CRP水平变化,并探讨其临床意义。方法选取HF-PEF患者108例和健康体检者81例为研究对象,比较两组患者SBP、DBP、BNP、HCY、CRP差异及不同NYHA分级间LVEF、BNP、HCY、CRP差异。结果与健康对照组比较,HF-PEF组SBP、DBP、BNP、HCY、CRP均显著升高,差异具有统计学意义(P<0.05)。NYHA分级3组患者的LVEF和血浆BNP、HCY、CRP水平比较有显著性差异,差异有统计学意义(F值分别为7.29、21.23、8.13、6.94,P值均<0.05);与NYHA分级Ⅱ级比较,NYHA分级Ⅲ级、Ⅳ级LVEF显著降低,BNP、HCY、CRP显著升高,差异均具有统计学意义(P<0.05);与NYHA分级Ⅲ级比较,NYHA分级Ⅳ级LVEF显著降低,BNP、HCY、CRP显著升高,差异均具有统计学意义(P<0.05)。Pearson相关性分析结果显示,血浆HCY与BNP、CRP呈显著正相关(r=0.764,r=0.535;P<0.05);血浆BNP与CRP无显著性相关(r=0.226,P>0.05)。结果 HF-PEF患者血浆HCY、BNP、CRP水平显著升高,且随HF-PEF病情的严重程度呈逐渐升高趋势。

Objective To evaluate the correlation and its significance of BNP,homocysteine and C-reactive protein level in elderly heart failure patients with preserved ventricular ejection fraction and hypertension.Methods 108 patients with HF-PEF and 81 healthy subjects were selected in the study,The differences of SBP,DBP,BNP,HCY,CRP in two groups and differences of LVEF,BNP,HCY,CRP in different NYHA classifications were compared. Results The SBP,DBP,BNP,HCY,CRP in HF-PEF group were significantly higher than these in healthy control group,the difference was statistically significant（P〈0. 05）.There were significant differences in LVEF and plasma BNP,HCY and CRP levels among the 3 groups of patients with NYHA,and the difference was statistically significant（F = 7. 29,21. 23,8. 13,6. 94,P〈0. 05）; The LVEF in NYHA classification Ⅲ and Ⅳ were significantly lower than that of NYHA classification Ⅱ,but the BNP,HCY,CRP level were significantly higher,the difference was statistically significant（P〈0. 05）; The LVEF in NYHA classification Ⅳ were significantly lower than that of NYHA classification Ⅲ,but the BNP,HCY,CRP level were significantly higher,the difference was statistically significant（P〈0. 05）. A significant positive correlation was observed between plasma HCY and BNP,CRP（ r = 0. 764,r = 0. 535; P〈0. 05）; There was no significant correlation between plasma BNP and CRP（ r = 0.226,P〈0. 05）. Conclusion Plasma HCY,BNP,CRP levels in patients with HF-PEF were significantly higher than witout and they are gradually increased with the severity of HF-PEF.