Hcy、CTnI及BNP在高血压合并射血分数保留型心力衰竭患者病情及预后评估中的价值分析

Analysis of the value of Hcy,CTnI and BNP in evaluating the condition and prognosis of hypertensive patients with ejection fraction preserving heart failure

目的:探究血清同型半胱氨酸(Homocysteine,Hcy)、心肌肌钙蛋白I(Cardiac Troponin I,CTnI)及脑钠肽(Brain Natriuretic Peptide,BNP)在高血压合并射血分数保留型心力衰竭(Heart Failure with Preserved LV Ejection Fraction,HF-PEF)病情、预后评估中的意义.方法:选择2020年1月至2022年5月间收治的116例高血压合并HF-PEF患者作为观察组研究对象,另选102例健康体检者作为对照组研究对象.按照心功能分级不同将观察组患者分为Ⅱ级、Ⅲ级、Ⅳ级.根据住院期间及出院半年内观察组是否发生主要不良心血管事件(Major Adverse Cardiovascular Events,MACE),将观察组进一步分为MACE组与非MACE组.分析对比两组血清Hcy、CTnI及BNP水平;分析对比不同心功能分级观察组患者的血清Hcy、CTnI及BNP水平;分析血清Hcy、CTnI及BNP对高血压合并HF-PEF预后评估的意义.结果:观察组Hcy、CTnI、BNP水平明显高于对照组(P<0.05);不同心功能分级患者血清Hcy、CTnI及BNP水平呈现Ⅱ级<Ⅲ级<Ⅳ级(P<0.05);MACE组与非MACE组在年龄性别方面无明显差异,在心功能分级、血清Hcy、CTnI及BNP水平等方面存在明显差异(P<0.05);采用多元Logistic回归分析得出心功能分级、Hcy、CTnI、BNP均是高血压合并HF-PEF患者发生MACE的影响因素.结论:血清Hcy、CTnI及BNP能有效评估高血压合并HF-PEF病情进展及预后情况,对于早期诊断与治疗有一定指导意义.

Objective:To explore the meaning of serum Homocysteine(Hcy),Cardiac Troponin I(CTnI)and Brain Natriuretic Peptide(BNP)in the assessment of the condition and prognosis of hypertensive Heart Failure with Preserved LV Ejection Fraction(HF-PEF).Methods:116 patients with hypertension combined with HF-PEF treated from January 2020 to May 2022 were selected as the observation group,and 102 healthy subjects were selected as the control group.According to different cardiac function grades,the observation group was divided into gradeⅡ,gradeⅢand gradeⅣ.According to the occurrence of Major Adverse Cardiovascular Events(MACE)during hospitalization and within six months after discharge,the observation group was further divided into MACE group and non-MACE group.The serum levels of Hcy,CTnI and BNP were analyzed and compared between the two groups.The serum levels of Hcy,CTnI and BNP were analyzed and compared in the observation group with different cardiac function grades.To analyze the significance of serum Hcy,CTnI and BNP in prognostic evaluation of hypertension complicated with HF-PEF.Results:The levels of Hcy,CTnI and BNP in observation group were significantly higher than those in control group(P<0.05).The levels of serum Hcy,CTnI and BNP in patients with different cardiac function grades were gradeⅡ<gradeⅢ<gradeⅣ(P<0.05).There were no significant differences in age and sex between MACE group and non-MACE group,but there were significant differences in cardiac function grade,serum Hcy,CTnI and BNP levels(P<0.05).Multiple Logistic regression analysis showed that cardiac function grading,Hcy,CTnI and BNP were all influential factors for MACE in patients with hypertension combined with HF-PEF.Conclusion:Serum Hcy,CTnI and BNP can effectively evaluate the progression and prognosis of hypertension combined with HF-PEF,which has certain guiding significance for early diagnosis and treatment.