中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
8期
862-865
,共4页
老年人,80岁以上%心力衰竭%利钠肽,脑
老年人,80歲以上%心力衰竭%利鈉肽,腦
노년인,80세이상%심력쇠갈%리납태,뇌
Aged,80 and over%Heart failure%Natriuretic peptide,brain
目的 观察不同心功能分级的80岁及以上慢性心力衰竭(CHF)患者血清胱抑素C、N端脑钠肽前体的表达水平及与心功能分级的关系,并探讨其临床意义. 方法 93例年龄≥80岁CHF患者(CHF组),按美国纽约心脏病学会心功能分级标准(NYHA)分为Ⅱ、Ⅲ、Ⅳ级,选取年龄≥80岁无CHF 44例(对照组).分别测定胱抑素C、N端脑钠肽前体及左心室射血分数等指标,并进行相关性分析. 结果 CHF组胱抑素C、N端脑钠肽及左心室射血分数水平与对照组比较差异有统计学意义(P＜0.01),随心功能级别的增加胱抑素C、N端脑钠肽水平也增加,左心室射血分数值则降低,且升高和降低在不同心功能分级组间两两比较差异亦有统计学意义(P＜0.01).相关性分析发现,N端脑钠肽前体与年龄、肌酐、尿素、尿酸呈正相关(r值分别为0.18、0.46、0.29和0.14,均P＜0.01);与左心室射血分数值呈负相关(r=-0.64,P＜0.01).胱抑素C与N端脑钠肽前体、年龄、肌酐、尿素、尿酸呈正相关(r值分别为0.65、0.30、0.51、0.41和0.23,均P＜0.01);与左心室射血分数值呈负相关(r=-0.76,P＜0.01).对干扰因素进行校正后,该相关性依然存在. 结论 80岁及以上CHF患者的胱抑素C浓度升高,并随心功能级别、N端脑钠肽前体的增高而递增,提示血清胱抑素C浓度对评估临床80岁及以上CHF患者心功能状况具有一定的参考价值.
目的 觀察不同心功能分級的80歲及以上慢性心力衰竭(CHF)患者血清胱抑素C、N耑腦鈉肽前體的錶達水平及與心功能分級的關繫,併探討其臨床意義. 方法 93例年齡≥80歲CHF患者(CHF組),按美國紐約心髒病學會心功能分級標準(NYHA)分為Ⅱ、Ⅲ、Ⅳ級,選取年齡≥80歲無CHF 44例(對照組).分彆測定胱抑素C、N耑腦鈉肽前體及左心室射血分數等指標,併進行相關性分析. 結果 CHF組胱抑素C、N耑腦鈉肽及左心室射血分數水平與對照組比較差異有統計學意義(P＜0.01),隨心功能級彆的增加胱抑素C、N耑腦鈉肽水平也增加,左心室射血分數值則降低,且升高和降低在不同心功能分級組間兩兩比較差異亦有統計學意義(P＜0.01).相關性分析髮現,N耑腦鈉肽前體與年齡、肌酐、尿素、尿痠呈正相關(r值分彆為0.18、0.46、0.29和0.14,均P＜0.01);與左心室射血分數值呈負相關(r=-0.64,P＜0.01).胱抑素C與N耑腦鈉肽前體、年齡、肌酐、尿素、尿痠呈正相關(r值分彆為0.65、0.30、0.51、0.41和0.23,均P＜0.01);與左心室射血分數值呈負相關(r=-0.76,P＜0.01).對榦擾因素進行校正後,該相關性依然存在. 結論 80歲及以上CHF患者的胱抑素C濃度升高,併隨心功能級彆、N耑腦鈉肽前體的增高而遞增,提示血清胱抑素C濃度對評估臨床80歲及以上CHF患者心功能狀況具有一定的參攷價值.
목적 관찰불동심공능분급적80세급이상만성심력쇠갈(CHF)환자혈청광억소C、N단뇌납태전체적표체수평급여심공능분급적관계,병탐토기림상의의. 방법 93례년령≥80세CHF환자(CHF조),안미국뉴약심장병학회심공능분급표준(NYHA)분위Ⅱ、Ⅲ、Ⅳ급,선취년령≥80세무CHF 44례(대조조).분별측정광억소C、N단뇌납태전체급좌심실사혈분수등지표,병진행상관성분석. 결과 CHF조광억소C、N단뇌납태급좌심실사혈분수수평여대조조비교차이유통계학의의(P＜0.01),수심공능급별적증가광억소C、N단뇌납태수평야증가,좌심실사혈분수치칙강저,차승고화강저재불동심공능분급조간량량비교차이역유통계학의의(P＜0.01).상관성분석발현,N단뇌납태전체여년령、기항、뇨소、뇨산정정상관(r치분별위0.18、0.46、0.29화0.14,균P＜0.01);여좌심실사혈분수치정부상관(r=-0.64,P＜0.01).광억소C여N단뇌납태전체、년령、기항、뇨소、뇨산정정상관(r치분별위0.65、0.30、0.51、0.41화0.23,균P＜0.01);여좌심실사혈분수치정부상관(r=-0.76,P＜0.01).대간우인소진행교정후,해상관성의연존재. 결론 80세급이상CHF환자적광억소C농도승고,병수심공능급별、N단뇌납태전체적증고이체증,제시혈청광억소C농도대평고림상80세급이상CHF환자심공능상황구유일정적삼고개치.
Objective To observe the correlation of serum levels of cystatin C (Cys C) and plasma N-terminal pro B-type natriuretic peptide (NT-pro BNP) with classification of cardiac function in elderly patients with chronic heart failure (CHF),and to explore its clinical significance.Methods 93 patients (aged ≥ 80 years) with CHF were considered as CHF group including degree Ⅱ,Ⅲ,Ⅳ (NYHA).44 patients (aged≥ 80 years) without CHF were selected as the control group.Cystatin C,NT-pro BNP levels and left ventricular ejection fraction (LVEF) were measured respectively,then their correlations were analyzed.Results There were significant differences in levels of CysC,NT-pro BNP and LVEF between the two groups (all P＜0.01).Along with the increasing of cardiac function classification,the Cys C and NT-pro BNP levels also increased,while LVEF decreased.The increments of Cys C and NT-pro BNP levels and decrements of LVEF had statistically significant differences between the two groups (all P＜ 0.01).Correlation analysis showed that,NT-pro BNP was positively correlated with age,creatine,blood urea nitrogen,Uric acid (r=0.18,0.46,0.29 and 0.14,all P＜0.01),and negatively correlated with the LVEF (r=-0.64,P＜0.01).Cys C was positively correlated with NT-pro BNP,age,creatine,blood urea nitrogen,Uric acid (r=0.65,0.30,0.51,0.41 and 0.23,all P＜0.01),and negatively correlated with LVEF (r=-0.76,P＜0.01).After adjusting for the interference factors,above correlations still existed.Conclusions Cys C concentration is significantly increased in very old patients with chronic heart failure,and it increases along with the increasing of the heart function classification and NT-pro BNP.The serum Cys C concentration has a certain reference value for the evaluation of cardiac function in very old patients with chronic heart failure.
