甲亢性心力衰竭患者血清B型钠尿肽及胱抑素C测定的临床意义

Clinical significance of determination of serum brain natriuretic peptide and cystatin C in patients with hyperthyroid heart failure

目的:探讨甲亢性心力衰竭患者血清B型钠尿肽(B-type natriuretic peptide,BNP)及胱抑素C(Cystatin C,Cys-C)检测的临床意义。方法:选择77例甲亢性心衰患者为观察组,并进行心功能分级,选取同期甲亢无心衰患者50例为对照组,所有患者进行血清游离甲状腺素(FT4)、游离三碘甲状原氨酸(FT3)、BNP及Cys-C水平检测,比较两组患者上述指标水平。结果:观察组患者血清FT3、FT4、BNP以及Cys-C水平均高于对照组(P<0.05);将观察组患者按照心功能分级进行分组,分为心功能Ⅱ级组、Ⅲ级组及Ⅳ级组,3个组患者血清FT3、FT4、BNP及Cys-C水平比较,差异均有统计学意义(P<0.05),各指标两组间比较,心功能Ⅳ级组均高于Ⅲ级组(P<0.05),同时Ⅲ级组均高于Ⅱ级组(P<0.05)。结论:血清BNP及Cys-C可作为临床评估甲亢性心衰患者病情严重程度的依据,值得临床推广应用。

Objective:To probe into the clinical effects of serum B-type natriuretic peptide(BNP)and cystatin C(Cys-C)in determination of patients with hyperthyroid heart failure.Methods:77 cases of hyperthyroid heart failure treated were selected as the observation group,and 50 cases of hyperthyroid without heart failure accompanied were selected as the control group.FT4,FT3,BNP and Cys-C levels were examined in all patients and compared between the two groups.Results:The levels of FT4,FT3,BNP and Cys-C in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).All patients in the observation group were divided into three groups according to different grades of cardiac function,NYHA grade II,NYHA grade III,and NYHA grade IV.There was a significant difference in the levels of t FT4,FT3,BNP and Cys-C among the three groups(P<0.05),NYHA grade IV higher than NYHA gradeⅢ(P<0.05),and NYHA grade III higher than NYHA grade II(P<0.05).Conclusion:The levels of BNP and CysC can be used as an important indicator of clinical judgment for the severity of hyperthyroid heart failure,and is worth promoting.