老年慢性心力衰竭患者胆红素与hs-CRP和NT-proBNP的相关性分析

Correlation analysis between bilirubin level and hs-CRP, NT-proBNP in elderly patients with chronic heart failure

目的探讨老年慢性心力衰竭(CHF)患者胆红素水平与超敏C反应蛋白(hs-CRP)、N末端B型脑钠肽前体(NT-proBNP)的相关性。方法选取2019年1—12月我院收治的94例老年CHF患者,根据美国纽约心脏病协会(NYHA)心功能分级,将其分为心功能Ⅱ级组32例、心功能Ⅲ级组31例、心功能Ⅳ级组31例,另筛选同期进行临床健康体检人员55例为对照组。比较4组患者胆红素、hs-CRP、NT-proBNP水平;采用Spearman秩相关性分析分别计算hs-CRP、NT-proBNP水平与血清胆红素水平的相关性。结果随着NYHA心功能分级的提高,NT-proBNP、直接胆红素、间接胆红素、总胆红素及hs-CRP水平逐渐增高,组间比较差异均有统计学意义(F=1 522.699、681.319、251.607、226.713、150.188,均P<0.05);血清胆红素与NT-proBNP、hs-CRP水平呈正相关(r=0.558、0.789、0.797、0.429、0.413、0.436,均P<0.05);随访1年发现,心血管事件组hs-CRP、NT-proBNP、血清胆红素水平明显高于非心血管事件组,组间比较差异均有统计学意义(t=11.412、11.926、8.434、4.353、5.035,均P<0.05)。结论动态监测老年CHF患者胆红素水平的变化,有助于预防心脏事件的发生,改善患者的预后。

Objective To explore the correlation between bilirubin level and N-terminal B-type brain natriuretic peptide precursor(NT-proBNP)and hypersensitive C-reactive protein(hs-CRP)in elderly patients with chronic heart failure(CHF). Methods All 94 elderly patients with CHF admitted to our hospital from Jan. to Dec. 2019 were divided into cardiac function class II group(n=32), cardiac function class III group(n=31)and cardiac function class IV group(n=31)according to the cardiac function classification of the New York Heart Association(NYHA). And 55 patients undergoing clinical health examinations during the same period were selected as the control group. hs-CRP and NT-proBNP in 4 groups were compared. The correlation between hs-CRP, NT-proBNP levels and serum bilirubin levels was calculated by Spearman rank correlation analysis. Results The levels of NT-proBNP, direct bilirubin, indirect bilirubin, total bilirubin and hs-CRP increased gradually with the increase of NYHA cardiac function classification, the difference among groups was statistically significant(F=1 522.699, 681.319, 251.607, 226.713, 150.188,all P<0.05);Serum bilirubin was positively correlated with NT-proBNP and hs-CRP levels(r=0.558, 0.789, 0.797, 0.429, 0.413, 0.436, all P<0.05);One-year follow-up showed that hs-CRP, NT-proBNP and serum bilirubin levels in the cardiovascular event group were significantly higher than those in the non-cardiovascular event group, the difference among groups was statistically significant(t=11.412, 11.926, 8.434, 4.353, 5.035,all P<0.05). Conclusion Dynamic monitoring of the changes of bilirubin in elderly CHF patients is helpful to prevent the occurrence of cardiac events and improve the prognosis of patients.