冠心病心力衰竭伴左心功能不全患者BNP、Cys-C水平与左心室功能不全的关系研究

The Relationship Between BNP,Cys-C Levels and Left Ventricular Dysfunction in Patients with Coronary Heart Disease Heart Failure and Left Ventricular Dysfunction

目的 探究B型利钠肽原(BNP)、胱抑素C(Cys-C)与冠心病心力衰竭患者左心室功能的关系。方法 将2020年2月至2021年6月许昌北海医院收治的52例冠心病心力衰竭伴左心功能不全患者纳入冠心病心衰组,以同期来院检查的健康体检者40例纳入对照组。检测所有受试者血清BNP、Cys-C水平;根据美国纽约心脏病协会(NYHA)对冠心病心衰组患者心功能进行分级,将其分为轻度组(Ⅱ级)、中度组(Ⅲ级)、重度组(Ⅳ级),并比较不同组别血清BNP、Cys-C水平;采用Spearman相关性分析血清BNP、Cys-C水平与冠心病心力衰竭伴左心功能不全患者左心室功能不全的关系;绘制受试者工作特征曲线(ROC)分析血清BNP、Cys-C水平对冠心病心力衰竭伴左心功能不全患者心功能不全的诊断价值。结果 血清BNP、Cys-C水平比较,冠心病心衰组显著高于对照组,差异有统计学意义(P<0.05);轻度组、中度组、重度组三组间血清BNP、Cys-C水平对比,其中中度组、重度组血清BNP、Cys-C水平高于轻度组,重度组血清BNP、Cys-C水平高于中度组,差异有统计学意义(P<0.05);Spearman相关系数分析显示,血清BNP、Cys-C水平与左心功能不全呈正相关,差异有统计学意义(r=0.942,r=0.720,P<0.05);ROC分析显示,血清BNP诊断冠心病心力衰竭患者左心功能不全的曲线下面积(AUC)、敏感度、特异性为0.941、82.40%、100.00%;血清Cys-C诊断冠心病心力衰竭伴左心功能不全患者心功能不全的AUC、敏感度、特异性为0.908、70.60%、94.40%,差异有统计学意义(P<0.05)。结论 冠心病心力衰竭伴左心功能不全患者血清BNP、Cys-C呈高表达,且左心功能不全越严重,其血清BNP、Cys-C水平越高。

Objective To explore the relationship between B-type natriuretic peptide(BNP),cystatin C(Cys-C) and left ventricular function in patients with coronary heart disease and heart failure.Methods A total of 52 patients with heart failure of coronary heart disease and left ventricular dysfunction admitted to Xuchang Beihai Hospital from February 2020 to June 2021were included in the coronary heart disease heart failure group,and 40 healthy people who came to the hospital for examination during the same period were included in the control group.Detection of all the subjects serum BNP,Cys-C level;According to the New York Heart Association(NYHA) classification of cardiac function,patients with heart failure were divided into mild group(grade Ⅱ),moderate group(grade Ⅲ) and severe group(grade Ⅳ),and the levels of serum BNP and Cys-C in different groups were compared.Spearman correlation was used to analyze the relationship between serum BNP and Cys-C levels and left ventricular dysfunction in patients with heart failure and left ventricular dysfunction of coronary heart disease.Receiver operating characteristic curve(ROC) was drawn to analyze the diagnostic value of serum BNP and Cys-C levels for cardiac dysfunction in patients with heart failure and left ventricular dysfunction of coronary heart disease.Results Comparison of serum BNP and Cys-C levels,coronary heart disease heart failure group was significantly higher than control group,with significant difference(P<0.05).There were significant differences in serum BNP and Cys-C levels among the mild group,moderate group and severe group(P<0.05).The serum BNP and Cys-C levels in the moderate group and severe group were higher than those in the mild group,and the serum BNP and Cys-C levels in the severe group were higher than those in the moderate group,with significant differences(P<0.05).Spearman correlation coefficient analysis showed that serum BNP and Cys-C levels were positively correlated with left cardiac insufficiency,with significant differences(r=0.942,r=0.720,P<0.05).ROC analysis showed that the area under the curve(AUC),sensitivity and specificity of serum BNP for the diagnosis of cardiac insufficiency in patients with coronary heart disease and heart failure were 0.941,82.40% and 100.00%.The AUC,sensitivity and specificity of serum Cys-C in the diagnosis of heart failure in patients with coronary heart disease and left ventricular dysfunction were 0.908,70.60%,94.40%,with significant differences(P<0.05).Conclusion The serum levels of BNP and Cys-C are high in patients with heart failure and left ventricular dysfunction of coronary heart disease,and the more serious the left ventricular dysfunction,the higher the serum levels of BNP and Cys-C.