天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (10): 1162-1165.doi: 10.11958/j.issn.0253-9896.2015.10.021

• 专题研究心血管疾病 • 上一篇    下一篇

慢性心力衰竭患者血清胱抑素C水平变化及临床意义

  

  1. 1天津医科大学研究生院 （邮编300070）； 2天津市人民医院心内科
  • 收稿日期:2015-03-23 修回日期:2015-05-05 出版日期:2015-10-15 发布日期:2015-10-22

Clinic significance of serum Cystain C level in patients with chronic heart failure#br#

  1. 1 Graduate School of Tianjin Medical University,Tianjin 300070,China； 2 Department of Cardiology, Tianjin Union Medical
    Center
  • Received:2015-03-23 Revised:2015-05-05 Published:2015-10-15 Online:2015-10-22

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摘要：

摘要： 目的 探讨血清胱抑素 C(Cys C)在慢性心力衰竭（CHF）患者中的表达水平及其与心功能、 心室重构的关
系。方法 入选 CHF 患者 75 例为 CHF 组， 按照 NYHA 分级分为 NYHAⅡ、 Ⅲ、 Ⅳ级组； 按照血清 Cys C 水平分组：
Cys C>0.95 mg/L 为 Cys C 水平升高组， Cys C≤0.95 mg/L 者为 Cys C 正常组； 按照左室射血分数 （LVEF） 分组： LVEF≥
0.50 为 LVEF 保留组， LVEF＜0.50 为非 LVEF 保留组； 入选 35 例老年健康体检者为对照组。分别测定 Cys C、 N 末
端 B 型利钠肽原 （NT-proBNP）、 血肌酐 （Scr）、 尿素 （UREA）、 心脏彩超等指标， 并进行相关性分析。结果 CHF 组患
者血清 Cys C 水平明显高于对照组， 且随着 NYHA 心功能分级增高， 其水平也随之升高； 与 Cys C 正常组比， Cys C 水
平升高组 NT-proBNP 较高， 而 LVEF 较低（均 P < 0.05）； 与非 LVEF 保留组比， LVEF 保留组 NT-proBNP、 左室舒张
末容积（LVEDD）、 左室质量指数（LVMI）、 Cys C 较低（均 P < 0.05）；Cys C 与年龄、 NT-proBNP、 LVEF、 LVEDD、 Scr、
UREA 相关 （r 分别为 0.411、 0.658、 -0.465、 0.310、 0.552、 0.486， P < 0.01）。结论 血清 Cys C 可用于评估早期心衰患
者的心功能状况， 与心室重构相关。

关键词: 心力衰竭, 心室重构, 胱抑素 C, 心肾综合征, N 末端 B 型利钠肽原

Abstract:

Abstract: Objective To explore serum Cystain C (Cys C) level in chronic heart failure (CHF) patients and its relation⁃
ship with cardiac function and ventricular remodeling. Methods Patients with heart failure (n=75) and healthy adult (n=35)
were enrolled in this study. According to the NYHA classification， CHF patients is divided into NYHA Ⅱ, NYHA Ⅲ and
NYHA Ⅳ； CHF patients can also be divided into 2 groups base on their level of serum Cys C: Cys C > 0.95 mg/L is defined
as elevated serum Cys C group, serum Cys C≤ 0.95 mg/L is defined as normal serum Cys C group; According to left ventricu⁃
lar ejection fraction (LVEF), CHF patients can also be divided into 2 groups: LVEF≥ 0.50 is defined as ejection fraction re⁃
served group, LVEF < 0.50 is defined as the ejection fraction reduced group. Cys C, N terminal B-type natriuretic peptide
(NT-proBNP), serum creatinine（Scr） ,UREA and Echocardiography were analyzed in all groups and their correlation was
studied. Results Serum Cys C level in CHF patients was obviously higher than that in healthy controls, and it increased
with NYHA heart function classification; compared with normal Cys C group， Cys C elevated group presented higher NTproBNP level but lower eGFR and LVEF (P < 0.05);compared with ejection fraction reduced group, ejection fraction reserved
group demonstrated lower NT-proBNP, LVEDD, LVMI and Cys C levels (all P < 0.05); Correlation analysis revealed that
Cys C is correlated with age, NT-proBNP, LVEF, LVEDD, Scr and UREA (r=0.411, 0.658, 0.465, 0.310, 0.552, 0.486, P <
0.01). Conclusion Serum Cys C can be used to evaluate cardiac function of heart failure, and is associated with ventricular
remodeling.

Key words: heart failure, ventricular remodeling, cystatin C, cardiorenal syndrome, NT-proBNP