血清同型半胱氨酸、超敏C反应蛋白水平对慢性心力衰竭预后的影响

Effect of serum Hcy and hs-CRP levels on prognosis in patients with chronic heart failure

目的通过检测慢性心力衰竭(CHF)患者血清中同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)水平,探讨Hcy、hs-CRP对CHF预后评估的影响。方法选取2014年1—12月在重庆市沙坪坝区人民医院心血管内科住院的CHF患者100例,治愈出院后随访12个月,失访8例。根据随访结果分为复发事件组(45例)和无复发事件组(47例),复发事件组包括心源性死亡患者及因心力衰竭恶化再次入院患者,分析各组患者首次住院期间的Hcy和hs-CRP水平,测定左心室射血分数(LVEF),评价Hcy和hs-CRP水平与LVEF的关系。结果复发事件组患者首次住院期间血清Hcy、hs-CRP水平明显高于无复发事件组,差异有统计学意义(P<0.05)。同时,复发事件组发生心源性死亡患者4例,占8.0%,其余为因心力衰竭恶化再次入院患者,占92.0%,死亡组与再次入院组患者首次住院期间血清Hcy、hs-CRP水平比较,差异均有统计学意义(P<0.05)。CHF患者血清Hcy、hs-CRP水平与LVEF均呈负相关(r=-0.037、-0.029,P<0.05)。结论 CHF患者血清Hcy、hs-CRP水平越高,治愈后发生复发心脏事件的风险越高。血清Hcy、hs-CRP水平可推荐作为CHF预后危险因素的检测指标,为CHF治愈后危险分层及预后评估提供一定的临床参考价值。

Objective To explore the effect of homocysteine(Hcy) and high sensitive C reactive protein(hs-CRP) on the prognosis evaluation of chronic heart failure(CHF) through detecting Hcy and hs CRP levels in the patients with CHF.Methods A total of 100 CHF inpatients treated in the vasculocardiology department of the hospital from January to December 2014 were selected and followed up for 12 months after discharge from hospital.Eight cases were lost to follow-up.The patients were divided into the recurrent event group(45 cases) and non-recurrence event group(47 cases) according to the follow up results.The recurrent event group included the cases of cardiogenic death and cases of re-hospitalization due to heart failure deterioration.Then the Hcy and hs-CRP levels at the first hospitalization period in each group were analyzed.The left ventricular ejection fraction(LVEF) was measured.The relationship between the Hcy and hs-CRP levels with recurrent event and LVEF was evaluated.Results The serum Hcy and hs-CRP levels during the first time hospitalization period in the recurrent event group were significantly higher than those in the non-recurrent event group,the difference was statistically significant(P<0.01).Meanwhile the recurrent event group had 4 cases of cardiogenic death,accounting for 8% of recurrent events,the rests were re-hospitalization cases due to heart failure deterioration,accounting for 92% of recurrent events.The levels of serum Hcy and hs-CRP during the first time hospitalization period had statistical difference between the two groups(P<0.05).The levels of serum Hcy and hs-CRP were negatively correlated with LVEF(r =-0.037,-0.029,P<0.05).Conclusion The higher the level of serum Hcy and hs-CRP in CHF patients,the higher the risk appearing recurrent cardiac event.Serum Hcy and hs-CRP levels can be recommended as the detection indicators of CHF prognosis risk factors.