血清胱抑素C和N末端脑钠肽前体与慢性心力衰竭患者疾病严重程度及预后的相关性分析

Correlations between Serum Cystatin C and N-terminal Brain Natriuretic Peptide Precursor with Severity Degree and Prognosis of Patients with Chronic Heart Failure

目的探讨血清胱抑素C(CysC)、 N末端脑钠肽前体(NT-proBNP)水平与慢性心力衰竭患者疾病严重程度和预后的相关性。方法选取我院2016年1月—2017年11月收治的慢性心力衰竭患者78例为观察组,另选取同期健康体检者78例为对照组。比较不同心功能分级者CysC、NT-proBNP和心功能指标水平。根据观察组患者住院期间是否发生死亡,分为存活组和死亡组;影响慢性心力衰竭患者预后的相关因素采用Logistic回归分析。结果观察组不同心功能分级患者CysC、NT-proBNP、左心室身因分数LVEF和左心室舒张期内径LVEDd水平均高于对照组(P<0.05),且CysC、NT-proBNP、LVEDd随心功能分级的增高而上升,LVEF水平随心功能分级的增高而下降(P<0.05)。CysC(≥1.25 mg/L)、NT-ProBNP(≥3200 ng/L)、LVEF(<55%)、心功能分级(Ⅲ～Ⅳ级)是慢性心力衰竭患者预后的独立危险因素(P<0.01)。结论 CysC、NT-proBNP水平随慢性心力衰竭患者的疾病严重程度而升高,CysC、NT-proBNP水平高的慢性心力衰竭患者,预后较差。

Objective To investigate correlations between serum cystatin C (CysC) and N-terminal brain natriuretic peptide precursor (NT-proBNP) levels with severity degree and prognosis of patients with chronic heart failure. Methods A total of 78 patients with chronic heart failure admitted during January 2016 and November 2017 were selected as observation group, and 78 healthy people taking physical examination at the same period were selected as control group. Levels of CysC, NT-proBNP and cardiac function indexes of patients with different cardiac function classification were compared. Observation group was divided into survival subgroup and death subgroup according to whether or not having death during hospitalization, and Logistic regression analysis was performed to analyze related factors affecting prognosis and death of patients with chronic heart failure. Results levels of CysC, NT-proBNP, left ventricular ejection fraction (LVEF) and left ventricular end diastolic dimension (LVEDd) in observation group were significantly higher than those in control group ( P <0.05), and levels of CysC, NT-proBNP and LVEDd were increased with increasing grade of cardiac function, while LVEF level was decreased with increasing grade of cardiac function ( P <0.05). CysC equal or more than 1.25 mg/L, the NT- proBNP equal or more than 3200 ng/L, LVEF less than 55% and Ⅲ-Ⅳ cardiac functional grading were independent risk factors affecting prognosis of patients with chronic heart failure ( P <0.001). Conclusion CysC and NT-proBNP levels are increased with increasing severity degree of patients with chronic heart failure, and chronic heart failure patients with higher CysC and NT-proBNP levels show poor prognosis.