摘要
目的:探讨血清胱抑素C(CysC)水平与缺血性心力衰竭(心衰)患者近期预后的关系。方法:采用颗粒增强免疫比浊法测定87例缺血性心衰患者血清CysC浓度等指标,以患者24h内首次血清CysC值作为基线,<1.8 mg/L者入血清CysC正常组(51例),≥1.8 mg/L者入高血清CysC组(36例)。记录住院期间及出院3个月内主要心血管事件、病死率和再入院率。结果:缺血性心衰高血清CysC组患者心血管事件、住院病死率、3个月病死率和再入院率都明显增加,与血清CysC正常组比较差异有统计学意义(P<0.01);相关分析显示血清CysC与肌酐、脑钠肽(BNP)呈显著正相关(P<0.05);应用Logistic回归分析发现高血清CysC为患者近期死亡的独立危险因素,而高血清CysC水平、脑钠肽、高敏C反应蛋白(Hs-CRP)、肌酐、入院时心功能、年龄、糖尿病史、心肌梗死史为近期发生主要心血管事件的独立危险因素。结论:血清CysC水平与缺血性心衰患者近期预后有密切的关系,血清CysC可作为缺血性心衰患者近期心血管事件及死亡的独立预测因子。
Objective：To evaluate the impact of serum level of cystatin C（CysC） on short term prognosis in patients with ischemic heart failure （IHF）.
Methods ： A total of 87 patients with IHF were involved in this study. Serum level of CysC was determined by particle-en- hanced immunonephelometric assay. The patients were divieded into two groups according to their baseline of the first CysC level within 24 hours of IHF. Normal CysC group ： CysC 〈 1.8mg/L（ n = 51 ）, and High CysC group ： CysC ≥ 1.8mg/L（ n = 36 ）. The clinical outcomes, major cardiac events, mortality during hospitalization, re-admission rate and 3 months follow-up period were evaluated by Logistic proportional hazard regression to examine the prediction of CysC on major cardiac events.
Results：Compared with Normal CysC group, the major cardiac events, mortality and re-admission rate were significantly higher in High CysC group（P 〈 0.01 ）. Serum level of CysC was obviously positively correlated to the levels of brain natriuretic peptide（BNP） and creatinine in all patients（ P 〈 0.05 ）. Logistic regression analysis indicated that elevated CysC was an independent predictor of short term mortality;while high level of CysC, BNP, high sensitivity C-reactive protein, creatinine, and the history of heart function, diabetes and myocardial infarction were the independent risk factors for short term major cardiac events in patients with IHF.
Conclusion：Serum level of CysC closely related to the short term prognosis of IHF,it was an independent predictor for major cardiac events and death in patients with IHF.
出处
《中国循环杂志》
CSCD
北大核心
2009年第1期28-31,共4页
Chinese Circulation Journal
关键词
缺血性心力衰竭
胱抑素C
脑钠肽
预后
Ischemic heart failure
Cystatin C
Brain natriuretic peptide
Prognosis
