NT-proBNP、CysC及cTnI在老年慢性心力衰竭中的表达及与不良心血管事件的关系

Expression of NT-proBNP,CysC and cTnI in elderly patients with refractory heart failure and their relationship with adverse cardiovascular events

目的分析氨基末端B型脑钠肽前体(NT-proBNP)、胱抑素C(CysC)及心肌肌钙蛋白T(cTnI)在老年慢性心力衰竭患者中的表达情况及与不良心血管事件(MACE)的关系。方法收集2020年1月至2021年1月山东省淄博市高青县人民医院收治的慢性心力衰竭患者131例(心衰组),另选取本院同期健康体检者122名作为对照组。对比不同人群中NT-proBNP、CysC、c TnI因子表达水平以及心功能指标[左房容积指数(LAVI)、左室质量指数(LVMI)、左心室射血分数(LVEF)];对比不同心功能指标与NT-proBNP、CysC及c TnI之间的相关性;分析影响患者发生MACE的相关因素。结果心衰组NT-proBNP、CysC及cTnI表达水平均明显高于对照组,差异均有统计学意义(P<0.05)。心衰组LAVI、LVMI明显高于对照组,LVEF则明显低于对照组,差异均有统计学意义(P<0.05)。NT proBNP、CysC及c TnI与患者LAVI、LVMI为正相关(r_(NT-proBNP)=0.558,r_(CysC)=0.577,r_(cTnI)=0.669,P均<0.001),与患者LVEF则为负相关性(r_(NT proBNP)=-0.620,r_(CysC)=-0.577,r_(cTnI)=-0.779,P均<0.001)。根据随访结果可知,131例患者中95例无MACE,36例MACE。MACE组合并基础疾病所占比例高于无MACE组,LVEF值低于无MACE组,NT-proBNP、CysC及cTnI表达水平则明显高于无MACE组,差异均有统计学意义(P<0.05)。条件Logistic回归模型分析显示,合并基础疾病、LVEF降低、NT-proBNP、CysC、cTnI升高为影响慢性心力衰竭患者发生MACE的独立危险因素(P<0.05)。结论NT-proBNP、CysC及cTnI在老年慢性心力衰竭患者中的表达均明显上升,且与患者心功能之间密切相关,三指标对评定患者近期预后有重要的临床价值。

Objective To analyze the expression of amino terminal B-type brain natriuretic peptide precursor(NT-probNP),cystatin C(CysC)and cardiac troponin I(cTnI)in elderly patients with refractory heart failure and its relationship with adverse cardiovascular events(MACE).Methods 131 patients with refractory heart failure admitted to People’s Hospital of Gaoqing County,Zibo City,Shandong Province from January 2020 to January 2021 were collected(heart failure group),and 122 healthy subjects in our hospital during the same period were selected as the control group.The expression levels of NT-proBNP,CysC and cTnI factors and cardiac function indexes in different populations were compared.The correlation between different cardiac function indexes and NT-proBNP,CysC and cTnI were compared.The related factors affecting the occurrence of MACE was analyzed.Results The expression levels of NT-pro BNP,CysC and cTnI in the heart failure group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The LAVI and LVMI in the heart failure group were significantly higher than those in the control group,while the LVEF was significantly lower than that in the control group,the differences were statistically significant(P<0.05).NT-pro BNP,CysC and cTnI were positively correlated with the LAVI and LVMI of patients(r_(NT-proBNP)=0.558,r_(CysC)=0.577,r_(cTnI)=0.669,all P<0.001),and were negatively correlated with the LVEF of patients(r_(NT proBNP)=-0.620,r_(CysC)=-0.577,r_(cTnI)=-0.779,all P<0.001).According to the follow-up results,95 of the 131 patients had no MACE,and 36 had MACE.The proportion of underlying diseases in the MACE group was higher than that in the non-MACE group,the LVEF value was lower than that in the non-MACE group,and the expression levels of NT-pro BNP,CysC and cTnI were significantly higher than those in the non-MACE group,the differences were statistically significant(P<0.05).Conditional Logistic regression model analysis showed that complicated underlying diseases,the decreasing of LVEF,and the increasing of NT-prob NP,CysC and cTnI were independent risk factors for MACE in patients with chronic heart failure(P<0.05).Conclusion The expressions of NT-pro BNP,CysC and cTnI in elderly patients with refractory heart failure are significantly increased and are closely related to the heart function of patients.The three indicators have important clinical value in assessing the short-term prognosis of patients.