保留射血分数的慢性心衰血清胱抑素C水平与心室重塑的相关性研究

Study on the Correlation between Serum Cystatin C Level and Ventricular Remodeling in Patients with Chronic Heart Failure with Preservation of Ejection Fraction

目的研究保留射血分数的慢性心衰患者血清胱抑素C水平与心室重塑的相关性。方法选取本社区2018年9月至2019年9月期间慢性病管理的32例心力衰竭患者作为研究对象,设为研究组,另选取同期在我社区进行常规体检的32例健康者作为对照研究对象,设为对照组,两组受试者均于入院后次日清晨空腹抽取静脉血,运用酶联免疫吸附法检测血清胱抑素C水平,同时行心脏多普勒超声检查,测量舒张末期左室内径、舒张末室间隔厚度、舒张末左室后壁厚度,运用Devereux的心室重量校正公式计算左室质量指数,对比分析两组受试者的血清胱抑素C水平与超声检查结果,分析血清胱抑素C水平与心室重塑的相关性。结果研究组的血清胱抑素C、N-末端脑钠肽、肌酐,尿素氮和尿酸水平均明显高于对照组,对比差异显著(P<0.05);对比研究组不同NYHA分级患者的血清胱抑素C水平,Ⅲ级、Ⅳ级均明显高于Ⅱ级,差异显著(P<0.05);Ⅳ级略高于Ⅲ级,差异不显著(P>0.05);对比两组受试者的心脏多普勒超声检查结果,研究组的LVEDd、SWTd、PWTd、LVMI均大于对照组,差异显著(P<0.05);射血分数保留的慢性心衰患者血清胱抑素C水平与LVEDd、SWTd、PWTd、LVM呈正相关(P<0.05)。结论射血分数保留的慢性心衰患者血清胱抑素C水平明显升高,血清胱抑素C水平与心室重塑具有一定的相关性,提示血清胱抑素C可作为评估射血分数保留的慢性心力衰竭患者心室重塑程度的评价指标。

Objective To investigate the correlation between serum cystatin C levels and ventricular remodeling in chronic heart failure patients with retained ejection fraction.Methods Select this community in September September 2018-September 2019 chronic disease management during the period of 32 patients with heart failure as the research object,set to the team,the other selection in the same period in my community for regular check-up 32 healthy subjects as control study object,set to the control group,two groups of subjects were the next morning fasting venous blood was drawn after admission,using enzyme-linked immunosorbent method to detect seruminhibition C level,at the same time line heart doppler ultrasound examination,measure the end-diastolic diameter left indoor,end-diastolic ventricular septal thickness,after the late diastolic left ventricular wall thickness,using Devereux ventricular weight correction formula left ventricular mass index,The serum cystatin C level and ultrasonic examination results of the two groups were compared to analyze the correlation between serum cystatin C level and ventricular remodeling.Results The levels of serum cystatin C,N-terminal brain natriuretic peptide,creatinine,urea nitrogen and uric acid in the study group were significantly higher than those in the control group(P<0.05).The serum cystatin C level of patients with different NYHA grades in the study group was significantly higher than that of patients with gradeⅢandⅣ(P<0.05).Ⅳwas slightly higher thanⅢwith no significant difference(P>0.05).Compared with the results of cardiac Doppler ultrasonography of the two groups,LVEDd,SWTd,PWTd and LVMI of the study group were all higher than those of the control group,with significant differences(P<0.05).Serum cystatin C levels in chronic heart failure patients with ejection fraction retention were positively correlated with LVEDd,SWTd,PWTd,and LVM(P<0.05).Conclusion Serum cystatin C level is significantly increased in chronic heart failure patients with ejection fraction retention,and there is a certain correlation between serum cystatin C level and ventricular remodeling,suggesting that serum cystatin C can be used as an evaluation index to evaluate the degree of ventricular remodeling in chronic heart failure patients with ejection fraction retention.