摘要
目的探讨老年慢性心力衰竭(CHF)患者血清同型半胱氨酸(Hcy)、胱抑素C的水平及意义。方法选取255例不同心功能分级的老年CHF患者,其中心功能Ⅱ级98例,心功能Ⅲ级87例,心功能Ⅳ级70例,以及同期的76例健康体检者,测定4组受试者的Hcy、胱抑素C及血脂水平,记录超声心动图指标,包括左心室射血分数(LVEF)、左心室舒张末内径(LVEDD)、左心室后壁(LVPW)、室间隔厚度(IVS)等指标,评价心功能分级并进行相关分析。结果正常对照组、不同心功能水平之间LVEF、LVEDD、LVPW、IVS、Hcy、胱抑素C、血脂水平差异均有统计学意义(P<0.05);Hcy、胱抑素C水平与心功能分级呈正相关(r=0.249、0.144,P均<0.01);胱抑素C与LVEDD、IVS、LVPW均呈正相关关系(r=0.167,0.114、0.231,P均<0.05)。结论 Hcy、胱抑素C水平均与心力衰竭严重程度密切相关,胱抑素C还可能参与心室重构过程,推测Hcy联合胱抑素C水平可作为判定老年CHF严重程度的参考指标。
Objective To investigate the serum level of homocysteine （Hcy）, cystatin C and its clinical significance with different NYHA status on congestive heart failure（CHF） in elderly patients. Methods The study selected 255 CHF patients, including 98 cases of NYHA II , 87 cases of NYHA HI , 70 cases of NYHA IV, and 76 healthy persons （normal control group） in the same period entered the study. Hcy, cystatin C and lipid levels of four groups were determined, and echocardiographic indicators of four groups were recorded, including left ventricular ejection fraction（LVEF）, left ventricular end-diastolic diameter（LVEDD）, left ventricular posterior wall（LVPW）, interventricular septum thickness （IVS） and other indicators to evaluate heart function classification and correlation analysis. Results LVEF, LVEDD, LVPW, IVS, Hcy, cystatin C, serum lipid levels among normal control group and different levels of cardiac function were significantly different（ P 〈0.05） ; Hcy, cystatin C levels were positively correlated to cardiac function（ r = 0. 249,0. 144, P 〈0.01） Cystatin C was positive correlated with LVEDD, IVS, LVPW（ r = 0. 167,0. 114, 0. 231, P 〈 0.05）. Conclusion Hey, cystatin C levels were closely associated with the severity of heart failure, cystatin C may also be involved in the process of ventricular remodeling, suggesting that Hcy joint cystatin C levels can be set as a judge in elderly CHF severity as reference indexes.
出处
《临床荟萃》
CAS
2015年第3期265-267,共3页
Clinical Focus
