中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2008年
28期
35-37
,共3页
苏月南%梁红峰%谭全达%宋明东%梁健
囌月南%樑紅峰%譚全達%宋明東%樑健
소월남%량홍봉%담전체%송명동%량건
心力衰竭,充血性%肾功能试验%半胱氨酸蛋白酶抑制剂
心力衰竭,充血性%腎功能試驗%半胱氨痠蛋白酶抑製劑
심력쇠갈,충혈성%신공능시험%반광안산단백매억제제
Heart failure,congestive%Kidney function tests%Cysteine proteinase inhibitors
目的 探讨半胱氨酸蛋白酶抑制剂C(cystatin C)对评价老年慢性充血性心力衰竭(CHF)患者早期肾损害的临床价值.方法 检测年龄≥65岁的慢性CHF患者(CHF组,60例)、心功能代偿期的心脏病患者(心功能代偿组,40例)及健康对照者(对照组,20例)的cystatin C水平,并与脑钠肽(BNP)以及LVEF进行相关性分析.结果 CHF组cystatin C水平[(1.86±0.37)mg/L]明显高于心功能代偿组[(1.32±0.56)mg/L]及对照组[(1.05±0.43)mg/L],P<0.01.cystatin C水平与BNP水平呈正相关(r=0.528,P<0.01),与LVEF呈负相关(r=-0.463,P<0.01).CHF组中BNP≥500ng/L者较BNP<500ng/L者cystatin C水平升高,且肾衰竭发生率增加.结论 cystatin C检测适用于老年慢性CHF患者早期肾损害的诊断.心力衰竭程度越重,肾小球滤过功能损害越明显,cystatin C水平越高.
目的 探討半胱氨痠蛋白酶抑製劑C(cystatin C)對評價老年慢性充血性心力衰竭(CHF)患者早期腎損害的臨床價值.方法 檢測年齡≥65歲的慢性CHF患者(CHF組,60例)、心功能代償期的心髒病患者(心功能代償組,40例)及健康對照者(對照組,20例)的cystatin C水平,併與腦鈉肽(BNP)以及LVEF進行相關性分析.結果 CHF組cystatin C水平[(1.86±0.37)mg/L]明顯高于心功能代償組[(1.32±0.56)mg/L]及對照組[(1.05±0.43)mg/L],P<0.01.cystatin C水平與BNP水平呈正相關(r=0.528,P<0.01),與LVEF呈負相關(r=-0.463,P<0.01).CHF組中BNP≥500ng/L者較BNP<500ng/L者cystatin C水平升高,且腎衰竭髮生率增加.結論 cystatin C檢測適用于老年慢性CHF患者早期腎損害的診斷.心力衰竭程度越重,腎小毬濾過功能損害越明顯,cystatin C水平越高.
목적 탐토반광안산단백매억제제C(cystatin C)대평개노년만성충혈성심력쇠갈(CHF)환자조기신손해적림상개치.방법 검측년령≥65세적만성CHF환자(CHF조,60례)、심공능대상기적심장병환자(심공능대상조,40례)급건강대조자(대조조,20례)적cystatin C수평,병여뇌납태(BNP)이급LVEF진행상관성분석.결과 CHF조cystatin C수평[(1.86±0.37)mg/L]명현고우심공능대상조[(1.32±0.56)mg/L]급대조조[(1.05±0.43)mg/L],P<0.01.cystatin C수평여BNP수평정정상관(r=0.528,P<0.01),여LVEF정부상관(r=-0.463,P<0.01).CHF조중BNP≥500ng/L자교BNP<500ng/L자cystatin C수평승고,차신쇠갈발생솔증가.결론 cystatin C검측괄용우노년만성CHF환자조기신손해적진단.심력쇠갈정도월중,신소구려과공능손해월명현,cystatin C수평월고.
Objective To investigate the clinical value of serum cystatin C in the early renal function impairment in elderly patients wtih chronic congestive heart failure (CHF). Methods Serum cystafin Cwas measured in 60 cases with chronic CHF (CHF group), 40 cases with cardiovascular diseases and compensated heart function (compensated heart function group), and other 20 elderly normal volunteers(controlgroup). The correlation between cystafin C, B-type natriuretic peptide (BNP) and LVEF was evaluated. Results The levels of eystatin C in CHF group [(1.86±0.37)mg/L]was higher than that in compensated heart function group [(1.32±0.56) mg/L]and control group [(1.05±0.43) mg/L], P < 0.01. Cystatin C was positively correlated with BNP (r = 0.528,P< 0.01)and negatively correlated with LVEF (r=-0.463, P<0.01). In CHF group, the level of cystatin C and the incidence rate of renal failure was higher in the patients with BNP≥500 ng/L than those with BNP < 500 ng/L. Conclusions Cystatin C is a marker dearly impairment of renal function in elderly patients with chronic CHF. The more severe the heart failure, the more obvious the glomorular filtration function impairment shows.