摘要
目的 探讨血清胱抑素C与慢性心力衰竭的关系及对心衰程度的评估价值.方法 入选住院心衰患者及年龄、性别匹配的对照组各64例,完成病史采集、超声心动图检查,测血压、心率,检测肾功能指标、血清胱抑素C及N末端B型脑钠肽前体浓度（NT-proBNP,pg/ml）.结果 ①心衰组血压、心率、肾功能指标、左房室结构参数、NT-proBNP及血清胱抑素C均较对照组显著升高（P＜0.01）,而射血分数较对照组明显下降（P＜0.01）.②心衰组Pearson相关分析显示,血清胱抑素C与年龄、尿素氮、肌酐、尿酸、左房内径、左室舒张末内径及NT-proBNP呈显著正相关（P＜0.05）,而与射血分数呈显著负相关（P＜0.01）.③心衰组多元逐步回归分析示,血清胱抑素C为NT-proBNP、左房内径、左室舒张末内径及射血分数的独立影响因素（P＜0.01）.④心衰组受试者工作特征曲线（ROC曲线）显示,血清胱抑素C及肌酐对中、重度临床心衰症状的诊断准确性分别为0.844和0.672,当血清胱抑素C＞0.89 mg/L或肌酐＞86.7 μmol/L时,就有可能伴有较重的临床症状.结论 血清胱抑素C与心衰患者心功能和心脏结构密切相关,并且是比血清肌酐更为可靠的评估心衰程度的临床指标.
Objective To explore the relationship and clinical evaluation of the serum cystatin C concen- tration in patients with chronic heart failure. Methods 64 patients with chronic ＇heart failure in hospital and 64 age-sex matched controls were recruited. Each subject finished questionnaire and echocardiography. Blood pressure, heart rate were measured and the serum concentration of kidney function indices, cystatin C and NT-proBNP were tested. Results （1）Compared to the control group, blood pressure, heart rate, kidney function indices, cardiac structure, serum levels of NT-proBNP and cystatin C were all significantly increased in heart failure group （P〈 0.01 ）, while ejection fraction was significantly decreased （P〈0.01）. （2）Pearson correlation analysis in heart failure group showed that cystain C was positively correlated with age, urea nitrogen, creatinine, uric acid, left atrium di- ameter, left ventricular end-diastolic diameter and NT-proBNP（P〈0.05 ）, while negatively correlated with ejection fraction（P〈0.01 ）. （3）Multivariate stepwise regression analysis indicated that cystatin C was independently associated with NT-pruBNP, left atrium diameter, left ventricular end-diastolic diameter and ejection fraction （P〈0.01）. （4） ROC curve revealed that cystatin C and creatinine have special prognostic value for the aggravated symptoms of heart failure. Conclusion Cystatin C is significantly associated with cardiac function and structure in patients with heart failure, and it is more valuable than creatinine to evaluate the aggravated symptoms of heart failure.
出处
《中国心血管病研究》
CAS
2015年第5期410-413,共4页
Chinese Journal of Cardiovascular Research
基金
常州市第十九批科技计划项目（应用基础研究）（项目编号：cJ20130032）
