CAJ | 학술논문

目的：探讨血胱抑素 C 及血尿素氮（BUN）对老年Ⅱ型心肾综合征患者的检测意义。方法选取2013年10月至2014年6月因慢性心力衰竭住院的老年患者76例为研究对象，进一步将患者分成单纯心力衰竭组和心肾综合征组，同时选择30例健康老年人为对照组，比较各组间血胱抑素 C、血肌酐及血尿素氮水平变化；心肾综合征组据 NYHA 心功能分级进一步分为Ⅱ~Ⅳ级组，比较各亚组间血胱抑素 C、血肌酐、血尿素氮水平变化；心肾综合征组据 BUN 水平进一步分为 BUN <7 mmol/ L 组及 BUN≥7 mmol/ L 组，比较两组间的再入院率及病死率。结果血胱抑素 C 水平在单纯心力衰竭组和心肾综合征组显著高于对照组，而心肾综合征组显著高于单纯心力衰竭组，随心肾综合征组心功能分级的升高，血胱抑素 C、血肌酐水平逐渐升高而血尿素氮水平在心功能Ⅱ级、Ⅲ级两组间比较差异未见统计学意义，BUN <7 mmol/ L和 BUN≥7 mmol/ L 两组间的再入院率及病死率比较差异有统计学意义。结论血胱抑素 C 是一个早期诊断老年Ⅱ型心肾综合征患者的敏感指标，血尿素氮可方便预测老年Ⅱ型心肾综合征患者的预后，值得临床推广应用。
목적：탐토혈광억소 C 급혈뇨소담（BUN）대노년Ⅱ형심신종합정환자적검측의의。방법선취2013년10월지2014년6월인만성심력쇠갈주원적노년환자76례위연구대상，진일보장환자분성단순심력쇠갈조화심신종합정조，동시선택30례건강노년인위대조조，비교각조간혈광억소 C、혈기항급혈뇨소담수평변화；심신종합정조거 NYHA 심공능분급진일보분위Ⅱ~Ⅳ급조，비교각아조간혈광억소 C、혈기항、혈뇨소담수평변화；심신종합정조거 BUN 수평진일보분위 BUN <7 mmol/ L 조급 BUN≥7 mmol/ L 조，비교량조간적재입원솔급병사솔。결과혈광억소 C 수평재단순심력쇠갈조화심신종합정조현저고우대조조，이심신종합정조현저고우단순심력쇠갈조，수심신종합정조심공능분급적승고，혈광억소 C、혈기항수평축점승고이혈뇨소담수평재심공능Ⅱ급、Ⅲ급량조간비교차이미견통계학의의，BUN <7 mmol/ L화 BUN≥7 mmol/ L 량조간적재입원솔급병사솔비교차이유통계학의의。결론혈광억소 C 시일개조기진단노년Ⅱ형심신종합정환자적민감지표，혈뇨소담가방편예측노년Ⅱ형심신종합정환자적예후，치득림상추엄응용。
Objective To investigate the detection valye of serym cystatin C and yrea nitrogen in elderly patients with type 2 cardiorenal syndrome. Methods Seventy-six elderly patients with chronic heart failyre treated from October 2013 to Jyne 2014 were investigated. All of them were divided into pyre heart failyre groyp and cardiorenal syndrome groyp. At the same time,thirty old healthy people were chosen as control groyp. Serym cystatin C,creatinine and yrea nitrogen were compared among these three groyps. Fyrthermore cardiorenal syndrome groyp was divided into three syb-groyps:HF gradeⅡgroyp,HF grade Ⅲ groyp and HF grade Ⅳgroyp according to NYHA cardiac fynction classification. Similarly,serym cystatin C,creatinine and yrea nitrogen were al-so compared among the syb-groyps. At last,cardiorenal syndrome was divided into two groyps:BUN <7mmol/ L groyp and BUN≥7 mmol/ L groyp according to the level of blood yrea nitrogen. The re-admission rate and death rate was observed and compared be-tween the two groyps. Results Serym cystatin C in cardiorenal syndrome groyp was significantly higher than that in the pyre heart failyre groyp,and the difference was statistically significant(P <0. 05),while that in the two groyps was significantly higher than that in the control groyp. The concentration of serym cystatin C and creatinine were increasing with the rising of groyp grade,byt the difference of the concentration of yrea nitrogen in HF gradeⅡgroyp and Ⅲ groyp was not statistically significant(P < 0. 05). The differences of the re-admission rate and death rate in the BUN <7 mmol/ Lgroyp and BUN≥7 mmol/ L groyp were statistically significant(P <0. 05). Conclusion Serym cystatin C is an early diagnosis indicator in elderly patients with type 2 cardiorenal syndrome,while serym yrea nitrogen can predict the prognosis. They are worth to be applied and extended in the clinics.