CAJ | 학술논문

目的：探讨血清 N 末端 B 型利钠肽原（NT-proBNP）和胱抑素 C（Cys-C）联合检测对Ⅱ型心肾综合征（CRS）的诊断价值。方法选择238例慢性心力衰竭患者，根据肾小球滤过率（GFR）水平将患者分为Ⅱ型 CRS 组130例（GFR＜60 ml/min）和单纯心力衰竭组108例（GFR＞60 ml/min）。分别采血检测两组 NT-proBNP 、Cys-C 和血清肌酐（Scr）水平并进行比较分析。结果Ⅱ型 CRS 组血清 NT-proBNP 、Cys-C 及 Scr 水平较单纯心力衰竭组明显升高（P 均＜0．01）。Ⅱ型 CRS 组中，NYHA 分级和肾功能分期越高，NT-proBNP 、Cys-C 及 Scr 水平也越高（NYHA 分级Ⅱ级＜Ⅲ级＜Ⅳ级，肾功能分期Ⅰ期＜Ⅱ期＜Ⅲ期＜Ⅳ期，P 均＜0．01）。结论血清 NT-proBNP 和 Cys-C 均可作为 CRS 的生物标志物，两者联合检测对判定患者的病情严重程度及预后有重要价值。
목적：탐토혈청 N 말단 B 형리납태원（NT-proBNP）화광억소 C（Cys-C）연합검측대Ⅱ형심신종합정（CRS）적진단개치。방법선택238례만성심력쇠갈환자，근거신소구려과솔（GFR）수평장환자분위Ⅱ형 CRS 조130례（GFR＜60 ml/min）화단순심력쇠갈조108례（GFR＞60 ml/min）。분별채혈검측량조 NT-proBNP 、Cys-C 화혈청기항（Scr）수평병진행비교분석。결과Ⅱ형 CRS 조혈청 NT-proBNP 、Cys-C 급 Scr 수평교단순심력쇠갈조명현승고（P 균＜0．01）。Ⅱ형 CRS 조중，NYHA 분급화신공능분기월고，NT-proBNP 、Cys-C 급 Scr 수평야월고（NYHA 분급Ⅱ급＜Ⅲ급＜Ⅳ급，신공능분기Ⅰ기＜Ⅱ기＜Ⅲ기＜Ⅳ기，P 균＜0．01）。결론혈청 NT-proBNP 화 Cys-C 균가작위 CRS 적생물표지물，량자연합검측대판정환자적병정엄중정도급예후유중요개치。
Objective To explore the diagnostic value of measurement of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP)combined with cystatin-C (Cys-C)in patients with typeⅡcardiore-nal syndrome (CRS). Methods A total of 238 patients with chronic heart failure were assigned to a type ⅡCRS group (n =130,GFR<60 ml/min)and a simple heart failure group (n =108,GFR>60 ml/min)ac-cording to the estimated glomerular filtration rate (GFR).The levels of serum NT-proBNP ,Cys-C and Scr of both groups were measured and compared. Results The levels of serum NT-proBNP,Cys-C and Scr in the type Ⅱ CRS group were significantly higher than those of the simple heart failure group (three P <0.01). In type Ⅱ CRS group,the higher the NYHA grade and renal function phase were,the higher the levels of ser-um NT-proBNP ,Cys-C and Scr were (NYHA grade Ⅱ<grade Ⅲ<grade Ⅳ,renal function phase<phaseⅡ<phase Ⅲ<phase Ⅳ,all P <0.01). Conclusion NT-proBNP and Cys-C can be used as biomarkers of CRS,combined NT-proBNP and Cys-C measurements has an important value of evaluating the severity and prognosis of CRS.