血清Cys C水平与慢性心力衰竭患者心室重塑的相关性研究

Correlation between serum Cystatin C level and ventricular remodeling in patients with chronic heart failure

目的 观察慢性心力衰竭(CHF)患者血清胱抑素C(Cys C)水平的变化与心室重塑的相关性,并探讨其临床意义。方法 将150例CHF患者(CHF组)按照美国纽约心脏病协会心功能分级标准(NYHA)进行分级,分为心功能Ⅱ级50例、心功能Ⅲ级50例、心功能Ⅳ级50例,选取非CHF患者50例作为对照组,分别检测血清Cys C、血清肌酐(Cr)、血清尿素氮(BUN)及心脏多普勒彩超相关指标,并行相关性分析。结果 不同心功能分级的CHF患者Cys C水平均比对照组高,差异有统计学意义( P <0.05);随着心功能分级的递增,其Cys C水平随之增高( P <0.05)。心脏彩超结果显示: CHF组左室舒张末内径(LVEDd)、左心室质量指数(LVMI)、左室射血分数(LVEF)指标与对照组比较,差异有统计学意义( P <0.05);随着心功能分级的递增,LVEDd、LVMI、LVEF水平也呈逐级递增趋势( P <0.05)。Cys C与LVEDd、LVMI、LVEF相关( r 分别是 0.539 、0.565、-0.541, P <0.05)。结论 CHF患者Cys C与心室重塑密切相关,可以反映CHF患者的心功能严重程度,从而尽早对心力衰竭早期明确诊断,及时予以对症支持治疗,改善其预后情况,提高患者生活质量。

Objective To observe the correlation between the changes of serum Cystatin C (Cys C) and ventricular remodeling in patients with chronic heart failure (CHF) and explore its clinical significance. Methods 150 CHF patients (CHF group)were classified according to the New York Heart Association (NYHA) and divided into grade Ⅱ(50 cases),grade Ⅲ(50 cases) and grade Ⅳ(50 cases).50 non-CHF patients were used as control group,which were selected to monitor serum Cys C,serum creatinine (Cr),Urea nitrogen (BUN) and related indexes of color Doppler echocardiography.Correlation analysis was performed. Results The levels of Cys C in CHF patients with different cardiac function grades were higher than those in control group,the difference was statistically significant ( P <0.05).The levels of Cys C increased with the increase of cardiac function grades ( P <0.05).The results of cardiac ultrasonography showed that the left ventricular end-diastolic meridian (LVEDd),left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) of the CHF group were compared with the control group,and the differences were statistically significant ( P <0.05).The levels of LVEDd,LVMI and LVEF increased gradually with the increase of cardiac function grading ( P <0.05).Cys C was related to LVEDd,LVMI and LVEF ( r was 0.539,0.565,-0.541, P < 0.05 ). Conclusion Cystatin C is closely related to ventricular remodeling in CHF patients,which can reflect the cardiac function of CHF patients,so as to make a definite diagnosis of CHF early,give timely symptomatic support treatment,improve the prognosis and improve the quality of life of CHF patients.