血清NT-proBNP、CRP、Cys-C与心力衰竭患者危险分层和预后的关系

Relationship between serum NT-proBNP,CRP,Cys-C and risk stratification and prognosis in patients with CHF

目的探究血清氨基末端脑钠肽前体(NT-proBNP)、C反应蛋白(C-reactive protein,CRP)、胱抑素-C(cystatin-C,Cys-C)与心力衰竭(congestive hearts failure,CHF)患者危险分层、预后的关系。方法选取2018年1月~2021年3月就诊的90例CHF患者,根据美国纽约心脏病协会(New York Heart Association,NYHA)分级分为轻度组(心功能Ⅰ、Ⅱ级)29例、中度组(心功能Ⅲ级)32例和重度组(心功能Ⅳ级)29例,根据治疗及随访情况将患者分为预后良好组和预后不良组。检测并比较各组入院血清NT-proBNP、CRP、Cys-C水平;分析NT-proBNP、CRP、Cys-C诊断危险分层价值及其与预后的相关性。结果血清NT-proBNP、CRP、Cys-C水平随着危险分层的升高而升高,差异有统计学意义(P<0.05);NTproBNP、CRP、Cys-C联合检测诊断CHF危险分层的灵敏度、特异性、准确度、阳性预测值、阴性预测值、ROC曲线下面积(area under curve,AUC)显著高于单一指标(P<0.05);与预后不良组比较,预后良好组血清NT-proBNP、CRP、Cys-C水平显著降低,差异有统计学意义(P<0.05);NTproBNP、CRP、Cys-C与预后良好组呈负相关,与预后不良组呈正相关,差异有统计学意义(P<0.05)。结论血清NT-proBNP、CRP、Cys-C与CHF患者危险分层、预后密切相关,对临床诊治有着较高的指导价值。

Objective To explore the relationship between serum N-terminal pro-B-type natriuretic peptide(NT-proBNP),C-reactive protein(CRP),Cystatin-C(Cys-C)and risk stratification and prognosis of patients with chronic heart failure(CHF).Methods A total of 90 CHF patients from January 2018to March 2021 were selected and divided into mild group(29 cases of cardiac function gradeⅠandⅡ),moderate group(32 cases of cardiac function gradeⅢ)and severe group(29 cases of cardiac function gradeⅣ)according to the New York Heart Association(NYHA)classification.According to the treatment and follow-up,the patients were divided into good prognosis group and poor prognosis group.The serum levels of NT-proBNP,CRP and Cys-C were detected and compared;The diagnostic value of NT-proBNP,CRP and Cys-C in risk stratification and their correlation with prognosis were analyzed.Results Serum NT-proBNP,CRP and Cys-C levels increased with the increase of risk stratification(P<0.05);The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and area under curve(AUC)of NT-proBNP,CRP and Cys-C combined detection in the diagnosis of CHF risk stratification were significantly higher than those of single index detection(P<0.05);Compared with the poor prognosis group,the serum NT-proBNP,CRP and Cys-C levels in the good prognosis group were significantly lower(P<0.05);NT-proBNP,CRP and Cys-C were negatively correlated with good prognosis group and positively correlated with poor prognosis group(P<0.05).Conclusion Serum NT-proBNP,CRP and Cys-C are closely related to risk stratification and prognosis of patients with CHF,which has high clinical guiding value for clinical diagnosis and treatment.