CAJ | 학술논문

目的评价心力衰竭(心衰)患者血胆红素与有创血液动力学监测指标、血浆N末端B型利钠肽原(NT-proBNP)和C反应蛋白(CRP)的相关性.方法对130例心衰患者在入院12 h内行漂浮导管监测和血总胆红素、血浆NT-proBNP和CRP等检测.结果肺毛细血管楔压[PCWP,(26.09比16.00)mm Hg(1mm Hg=0.133 kPa)]、NT-proBNP[(3.36比2.91)pmol/L]和左室射血分数[(34.12比28.92)%]在高总胆红素血症组均较正常血总胆红素组显著增高(P值均<0.05).血总胆红素水平在高水平PCWP、右房压和NT-proBNP组较低水平组显著增高[(32.22比24.17)、(37.52比24.19)、(32.14比16.74)pmol/L,P值均<0.05].血总胆红素分别与NT-proBNP和右房压独立相关(β=0.39;β=0.29,P值均<0.01).结论心衰患者血总胆红素水平与右房压、PCWP和血浆NT-proBNP密切相关,是有助于心衰患者准确临床评价的重要生化指标.
목적 평개심력쇠갈(심쇠)환자혈담홍소여유창혈액동역학감측지표、혈장N말단B형리납태원(NT-proBNP)화C반응단백(CRP)적상관성.방법 대130례심쇠환자재입원12 h내행표부도관감측화혈총담홍소、혈장NT-proBNP화CRP등검측.결과 폐모세혈관설압[PCWP,(26.09비16.00)mm Hg(1mm Hg=0.133 kPa)]、NT-proBNP[(3.36비2.91)pmol/L]화좌실사혈분수[(34.12비28.92)%]재고총담홍소혈증조균교정상혈총담홍소조현저증고(P치균<0.05).혈총담홍소수평재고수평PCWP、우방압화NT-proBNP조교저수평조현저증고[(32.22비24.17)、(37.52비24.19)、(32.14비16.74)pmol/L,P치균<0.05].혈총담홍소분별여NT-proBNP화우방압독립상관(β=0.39;β=0.29,P치균<0.01).결론 심쇠환자혈총담홍소수평여우방압、PCWP화혈장NT-proBNP밀절상관,시유조우심쇠환자준학림상평개적중요생화지표.
Objective To explore the correlation among serum total bilirubin (TBil) , invasive hemodynamic parameters, plasma N-terminal proBNP (NT-preBNP) and C reactive protain (CRP)in patients with heart failure. Methods Invasive hemodynamic parameters derived from Swan-Ganz catheter, TBil, plasma NT-proBNP and CRP within 12 hours after hospital admission were analyzed in 130 patients with chronic heart failure [Now York Heart Association (NYHA) class Ⅱ -Ⅳ]. Results Compared with those in non-hyperbilirubinemia group, pulmonary capillary wedge pressure (PCWP), NT-proBNP and left ventriculure ejection fraction were different significantly in total hyperbilirubinemia group [(26. 09 vs 16.00) mm Hg(1 mm Hg =0. 133 kPa), (3.36 vs2.91) pmol/L, (34. 12 vs 28.92)%, P<0. 05]. The serum TBil increased significantly in higher PCWP, right atrial pressure and NT-proBNP groups than those in lower level groups [(32. 22 vs 24. 17), (37.52 vs 24. 19), (32. 14 vs 16. 74) pmol/L, P < 0.05]. Partial correlation analysis showed serum TBil was associated with PCWP, right atrial pressure, pulmonary vascular resistance index and NT-proBNP respectively (r = 0. 21, P = 0. 02; r = 0. 33, P < 0. 01 ; r = 0. 20, P =0. 04;r = 0. 37, P <0. 01, respectively). Multiple linear regression analysis showed both right atrial pressure and NT-proBNP correlated independently with serum TBil(β= 0. 39, P < 0. 01 ;β = 0. 29,P = 0. 01, respectively). Conclusion For patients with heart failure, serum TBil correlated well with right atrial pressure, PCWP and NT-proBNP; it is a reliable indicator for exact clinical evaluation of heart failure.