UMA、BNP、hsCRP及UACR联合检测对慢性心衰患者的诊治及预后评估的价值

Diagnosis and prognosis value of combined detection of UMA, BNP, hs-CRP and UACR on patients with chronic heart failure

目的探讨联合检测尿微量白蛋白(UMA)、脑钠肽(BNP)、超敏C-反应蛋白(hs-CRP)及尿白蛋白比肌酐比率(UACR)在慢性心衰患者的诊治及预后评估中的应用价值。方法选取本院2014年5月至2015年5月住院慢性心衰(CHF)患者共80例为观察组,40例健康体检者为对照组,联合检测UMA、BNP、hs-CRP及UACR水平,比较两组及观察组治疗前后的各指标的差异。结果观察组治疗过程中死亡8例、3例中途退出。观察组患者治疗前的UMA、BNP和hs-CRP水平分别为(32.1±16.5)mg/L、(399.8±187.6)pg/m L和(31.5±18.9)mg/L,均明显高于健康对照组的(11.3±5.4)mg/L、(59.3±16.7)pg/m L和(5.0±2.4)mg/L,差异均有显著统计学意义(P<0.01);观察组患者治疗后的UMA、BNP及hs-CRP水平分别为(15.1±3.0)mg/L、(258.7±122.0)pg/m L、(14.5±5.4)mg/L,与治疗前比较均明显降低,差异均有显著统计学意义(P<0.01);不同NYHA分级的UACR水平比较差异有统计学意义(F=128.71,P<0.05),且UACR水平与不同心功能分级呈正相关(r=0.71,P<0.01)。结论 UMA、BNP、hs-CRP及UACR联合检测对CHF的诊治及预后评估具有重要的临床价值。

Objective To investigate the diagnosis and prognosis value of combined detection of urine micro albumin(UMA), brain natriuretic peptide(BNP), high sensitivity C reactive protein(hs-CRP), urinary albumin to creatinine ratio(UACR) on patients with chronic heart failure. Methods A total of 80 patients with chronic heart failure, who admitted to our hospital from May 2014 to May 2015, were selected as the observation group, and 40 healthy volunteers were chosen as the control group. The significances of the level of UMA, BNP and hs-CRP between the observation group and control group were investigated, and the differences between before and after treatment were studied in the observation group too.Results During the treatment, there are eight cases of death and three cases of midways withdraw in the observation group.Before the treatment, the level of UMA [(32.1±16.5) mg/L], BNP [(399.8±187.6) pg/m L] and hs-CRP [(31.5±18.9) mg/L]in the observation group were significantly higher than those in the control group [(11.3±5.4) mg/L,(59.3±16.7) pg/m L,(5.0±2.4) mg/L, respectively](t=7.68, 11.79, 8.93, P<0.01). The level of UMA [(15.1±3.0) mg/L], BNP [(258.7±122.0) pg/m L]and hs-CRP [(14.5 ± 5.4) mg/L] after the treatment were significantly lower than before the treatment(P<0.01). There were significant differences in UACR levels among different NYHA grades(F=128.71, P<0.05); UACR level was positively correlated with the grade of cardiac function(r=0.71, P<0.01). Conclusion Combined detection of UMA, BNP,hs-CRP and UACR has important clinical value in the diagnosis, treatment and prognosis of chronic heart failure.