血浆儿茶酚抑素对慢性收缩性心力衰竭患者预后的预测价值

Predictive Value of Plasma Catestatin in Prognosis of Patients with Chronic Systolic Heart Failure

目的 :探讨血浆儿茶酚抑素(CST)对慢性收缩性心力衰竭患者预后的预测价值。方法 :选取我院2012年12月—2016年12月收治的180例慢性收缩性心力衰竭患者,依据CST浓度四分位数间距分为四组:CST-L_1组(≤60.24 ng/L)、CST-L_2组(60.25~76.57 ng/L)、CST-M组(76.58~86.33 ng/L)、CST-G组(≥86.34 ng/L),各45例。回顾性分析并比较四组临床资料、住院期间心脏不良事件发生情况。结果 :四组年龄、性别、体质量指数(BMI)、血红蛋白、总胆红素、红细胞计数、红细胞体积、心肌病、冠心病、瓣膜病以及高血压等比较,差异无统计学意义(P>0.05)。CST水平升高时收缩压(SBP)、舒张压(DBP)、超敏C-反应蛋白(hs-CRP)、N-末端脑钠肽前体(NT-proBNP)、左心室舒张末内径(LVEDD)及右心室舒张末内径(RVEDD)呈上升趋势,左心室射血分数(LVEF)呈下降趋势(P<0.05)。SBP、DBP、hs-CRP、NT-proBNP、LVEDD及RVEDD与CST水平呈正相关(r=0.935,0.952,0.958,0.963,0.994,0.985),LVEF与CST水平呈负相关(r=-0.974)。恶性心律失常、急性心力衰竭等症状的发生率随着CST水平的升高发生率明显升高;梗死后心绞痛或再梗死、死亡的发生率随CST水平升高有增加的趋势。结论 :血浆CST水平与慢性收缩性心力衰竭病情发展相关,CST水平升高,则死亡风险增加。

Objective: To investigate the predictive value of plasma catestatin(CST) in the prognosis of patients with chronic systolic heart failure. Methods: 180 cases of patients with chronic systolic heart failure admitted to our hospital from December 2012 to December 2016 were enrolled and divided into four groups according to CST concentration quartile interval: CST-L_1 group(≤60.24 ng/L), CST-L_2 group(60.25~76.57 ng/L), CST-M group(76.58~86.33 ng/L) and CST-G group(≥86.34 ng/L), 45 cases in each group. Clinical data and occurrence of cardiac adverse events during hospitalization period in the four groups were retrospectively analyzed and compared. Results: There were no significant differences in age, gender, body mass index(BMI), hemoglobin, total bilirubin, red blood cell count, red blood cell volume, cardiomyopathy, coronary heart disease, valvular disease and hypertension between the four groups(P>0.05). Systolic blood pressure(SBP), diastolic blood pressure(DBP), hypersensitive C-reactive protein(hs-CRP), N-terminal pro-brain natriuretic peptide(NTproBNP), left ventricular end-diastolic diameter(LVEDD) and right ventricular end diastolic diameter(RVEDD) showed an upward trend, and left ventricular ejection fraction(LVEF) showed a downward trend when CST level increased(P<0.05). SBP, DBP, hs-CRP, NT-proBNP, LVEDD and RVEDD were positively correlated with CST level(r =0.935, 0.952, 0.958, 0.963, 0.994, 0.985), and LVEF was negatively correlated with CST level(r =-0.974). The incidences of symptoms such as malignant arrhythmia and acute heart failure increased significantly with the increase of CST level; the incidence of post-infarction angina or re-infarction and death increased with the increase of CST level. Conclusion: Plasma CST level is associated with the development of chronic systolic heart failure, and increased CST level increases the risk of death.