血清Hcy及NT-pro-BNP与慢性心力衰竭患者临床预后的相关性研究

Study on the Correlation between Serum Hcy and NT-pro-BNP and Clinical Prognosis of Patients with Chronic Heart Failure

目的:探究血清同型半胱氨酸(Hcy)及N末端脑钠肽前体(NT-pro-BNP)与慢性心力衰竭(CHF)患者临床预后的相关性。方法:纳入2017年1月至2019年3月我院心内科收治的70例CHF患者作为观察组,以及同期来院体检的70例健康人员作为对照组,比较两组患者超声检测指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)]以及血清Hcy、NT-pro-BNP水平;采用Spearman相关性分析血清Hcy、NT-pro-BNP与LVEF、LVEDD的相关性;观察组患者予以抗心衰治疗,出院后1年内随访心血管不良事件(MACE)发生情况,根据随访结果分为MACE组和非MACE组,并进行组间血清Hcy、NT-pro-BNP水平比较。结果:观察组LVEF小于对照组,LVEDD以及血清Hcy、NT-pro-BNP均显著高于对照组,差异均有统计学意义(P均<0.05);Spearman相关性分析结果显示,血清Hcy、NT-pro-BNP均与LVEF呈负相关(r=-0.867、-0.892,P均<0.05),与LVEDD呈正相关(r=-0.812、0.870,P均<0.05);MACE组血清Hcy、NT-pro-BNP均显著高于非MACE组(P均<0.05)。结论:CHF患者血清Hcy、NT-pro-BNP水平与心功能密切相关,可为预测临床预后提供依据。

Objective:To explore the correlation between serum homocysteine(Hcy)and N-terminal pro-brain natriuretic peptide(NT-pro-BNP)and clinical prognosis of patients with chronic heart failure(CHF).Methods:70 cases of CHF patients admitted to department of cardiology of our hospital from January 2017 to March 2019 were included as observation group,and 70 healthy persons who came to the hospital for physical examination during the same period were selected as control group.The ultrasound detection indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)]and serum Hcy and NT-pro-BNP levels were compared between the two groups.Spearman correlation analysis was used to analyze the correlation between serum Hcy and NT-pro-BNP and LVEF and LVEDD.Patients in observation group were treated with anti-heart failure therapy.The occurrence of major adverse cardiovascular events(MACE)were followed up within 1 year after discharge.According to the follow-up results,the patients were divided into MACE group and non-MACE group,and the serum Hcy and NT-pro-BNP levels were compared between the groups.Results:The LVEF of observation group was less than that of control group while the LVEDD and serum Hcy,NT-pro-BNP were significantly higher than those of control group(all P<0.05).Spearman correlation analysis showed that serum Hcy and NT-pro-BNP were negatively correlated with LVEF(r=-0.867,-0.892,all P<0.05),and were positively correlated with LVEDD(r=0.812,0.870,all P<0.05).Serum Hcy and NT-pro-BNP of MACE group were significantly higher than those of non-MACE group(all P<0.05).Conclusion:Serum Hcy and NT Pro BNP levels are closely related to cardiac function in patients with CHF,which can provide basis for predicting clinical prognosis.