胱抑素C与多发性肌炎/皮肌炎合并心力衰竭关系的横断面研究

Relationship between Cystatin C and Polymyositis/Dermatomyositis Complicated with Heart Failure:a Cross-Sectional Study

目的探讨胱抑素C与多发性肌炎/皮肌炎合并心力衰竭的关系。方法本研究为横断面研究,根据是否合并心力衰竭将病人分为两组,采用多因素分析方法统计胱抑素C与多发性肌炎/皮肌炎合并心力衰竭的关系。结果共纳入病人122例,其中10例(8.2%)病人合并心力衰竭。合并心力衰竭组发生吞咽困难(P=0.017)、心包积液(P=0.006)以及入院前使用糖皮质激素(P=0.018)的频率更高;同时,其总胆固醇(P=0.003)、低密度脂蛋白胆固醇(P=0.003)、血清肌酐(P=0.030)、胱抑素C(P=0.005)以及心率(P=0.016)亦较高;另外,这些病人左心室内径(P=0.000)和右心室内径(P=0.035)较大,而左室射血分数(P=0.000)较小。Logistic回归提示胱抑素C与心力衰竭密切相关,且作用独立于血清肌酐及C反应蛋白之外。ROC曲线则显示胱抑素C≥1.39 mg/L时有一定的敏感性和特异性。结论胱抑素C与多发性肌炎/皮肌炎合并心力衰竭相关,较高水平的胱抑素C对于判别心力衰竭有一定意义。

Objective To investigate the relationship between cystatin C and polymyositis/dermatomyositis complicated with heart failure.Methods This study was a cross-sectional study.Patients were divided into two groups based on whether they had heart failure.Multivariate analysis was used to assess the relationship between cystatin C and polymyositis/dermatomyositis complicated with heart failure.Results A total of 122 patients were included,of which 10(8.2%)patients had heart failure.Patients complicated with heart failure had a higher frequency of dysphagia(P=0.017),pericardial effusion(P=0.006),and use of glucocorticoid(P=0.018),and had higher levels of total cholesterol(P=0.003),low-density lipoprotein cholesterol(P=0.003),serum creatinine(P=0.030),cystatin C(P=0.005),and heart rate(P=0.001).In addition,the left ventricular diameter(P=0.000)and right ventricular diameter(P=0.035)were larger,while the left ventricular ejection fraction(P=0.000)was smaller in these patients.Logistic regression suggested that cystatin C was closely related to heart failure,and its effect was independent of serum creatinine and C-reactive protein.The receiver operating characteristic(ROC)curve showed a certain sensitivity and specificity for discriminating heart failure when cystatin C Was≥1.39 mg/L.Conclusion Cystatin C is associated with polymyositis/dermatomyositis complicated with heart failure.Higher levels of cystatin C are of certain significance in identifying heart failure.