无心衰症状的ASCVD老年患者BNP及CRP的监测及临床意义

BNP and CRP monitoring and the clinical significance for senile ASCVD patients without heart failure symptoms

目的探讨早期监测血浆超敏C反应蛋白(hs-CRP)和B型脑钠肽(BNP)对无心衰症状的老年动脉粥样硬化性心血管疾病(ASCVD)患者的临床意义。方法选取NYHA心功能分级Ⅰ~Ⅱ级且无明显临床症状的86例ASCVD老年患者作为观察组,另选择88名老年健康者作为正常对照组,比较两组血浆hs-CRP水平和BNP水平。结果观察组hs-CRP(5.61±2.96)mg/L和BNP(126.7±66.9)pg/ml水平均显著高于对照组(3.37±2.83)mg/L和(57.5±24.5)pg/ml(P<0.05);根据观察组患者的基础疾病情况,将患者进一步分为陈旧性心肌梗死组、稳定型心绞痛组、缺血性脑卒中组、外周动脉粥样硬化性疾病组,各组间hs-CRP及BNP水平比较无显著性差异(P>0.05)。结论无心衰症状的ASCVD老年患者的血浆hs-CRP及BNP水平显著升高,提示此类患者发生心衰的风险较高。对其应进行常规BNP和hs-CRP水平监测,以早期发现潜在心衰风险患者,早期依据心衰指南进行上游抗心衰药物干预,改善预后。

Objective To explore the clinical significance of monitoring plasma hypersensitive C-reactive protein(hs-CRP)and B-type natriuretic peptide(BNP)in early stage for senile patients with atherosclerotic cardiovascular disease(ASCVD)but no heart failure symptoms.MeAods A total of 86 senile ASCVD patients with HYHA heart function grade I-II but no obvious clinical symptoms"were selected to constitute an observation group and another 88 healthy senile people"were selected to constitute a control group.The plasma hs-CRP and BNP levels"were compared.Rulte The observation group show,ed higher hs-CRP(5.61±2.96)mg/L and BNP(126.7±66.9)pg/ml levels than the control group(3.37±2.83)mg/L and(57.5±24.5)pg/ml respectively(P<0.05).The patients were further categorized into an old myocardial infarction group,a stable angina pectoris group,an ischemic stroke group and a PASO group according to the underlying diseases.According to Table 2,there were no significant differences in hs-CRP and BNP levels among the groups(P>0.05).Conclusion Plasma hs-CRP and BNP levels are significantly higher in senile ASCVD patients without heart failure symptoms,indicating that the risk of heart failure is high for these patients.The said patients shall be subject to conventional monitoring over BNP and hs-CRP levels to detect potential patients of heart failure in early stage,so that upstream antiheart failure medicine intervention can be performed according to heart failure guide so as to improve the prognosis.