CAJ | 학술논문

目的：探讨血清胱抑素C(Cys C)在慢性心力衰竭（CHF）患者中的表达水平及其与心功能、心室重构的关系。方法入选CHF患者75例为CHF组，按照NYHA分级分为NYHAⅡ、Ⅲ、Ⅳ级组；按照血清Cys C水平分组：Cys C>0.95 mg/L为Cys C水平升高组，Cys C≤0.95 mg/L者为Cys C正常组；按照左室射血分数（LVEF）分组：LVEF≥0.50为LVEF保留组，LVEF＜0.50为非LVEF保留组；入选35例老年健康体检者为对照组。分别测定Cys C、N末端B型利钠肽原（NT-proBNP）、血肌酐（Scr）、尿素（UREA）、心脏彩超等指标，并进行相关性分析。结果 CHF组患者血清Cys C水平明显高于对照组，且随着NYHA心功能分级增高，其水平也随之升高；与Cys C正常组比，Cys C水平升高组NT-proBNP较高，而LVEF较低（均P<0.05）；与非LVEF保留组比，LVEF保留组NT-proBNP、左室舒张末容积（LVEDD）、左室质量指数（LVMI）、Cys C较低（均P<0.05）；Cys C与年龄、NT-proBNP、LVEF、LVEDD、Scr、UREA相关（r分别为0.411、0.658、-0.465、0.310、0.552、0.486，P<0.01）。结论血清Cys C可用于评估早期心衰患者的心功能状况，与心室重构相关。
목적：탐토혈청광억소C(Cys C)재만성심력쇠갈（CHF）환자중적표체수평급기여심공능、심실중구적관계。방법입선CHF환자75례위CHF조，안조NYHA분급분위NYHAⅡ、Ⅲ、Ⅳ급조；안조혈청Cys C수평분조：Cys C>0.95 mg/L위Cys C수평승고조，Cys C≤0.95 mg/L자위Cys C정상조；안조좌실사혈분수（LVEF）분조：LVEF≥0.50위LVEF보류조，LVEF＜0.50위비LVEF보류조；입선35례노년건강체검자위대조조。분별측정Cys C、N말단B형리납태원（NT-proBNP）、혈기항（Scr）、뇨소（UREA）、심장채초등지표，병진행상관성분석。결과 CHF조환자혈청Cys C수평명현고우대조조，차수착NYHA심공능분급증고，기수평야수지승고；여Cys C정상조비，Cys C수평승고조NT-proBNP교고，이LVEF교저（균P<0.05）；여비LVEF보류조비，LVEF보류조NT-proBNP、좌실서장말용적（LVEDD）、좌실질량지수（LVMI）、Cys C교저（균P<0.05）；Cys C여년령、NT-proBNP、LVEF、LVEDD、Scr、UREA상관（r분별위0.411、0.658、-0.465、0.310、0.552、0.486，P<0.01）。결론혈청Cys C가용우평고조기심쇠환자적심공능상황，여심실중구상관。
Objective To explore serum Cystain C (Cys C) level in chronic heart failure (CHF) patients and its relation?ship with cardiac function and ventricular remodeling. Methods Patients with heart failure (n=75) and healthy adult (n=35) were enrolled in this study. According to the NYHA classification,CHF patients is divided into NYHA Ⅱ, NYHAⅢand NYHAⅣ;CHF patients can also be divided into 2 groups base on their level of serum Cys C:Cys C>0.95 mg/L is defined as elevated serum Cys C group, serum Cys C≤0.95 mg/L is defined as normal serum Cys C group;According to left ventricu?lar ejection fraction (LVEF), CHF patients can also be divided into 2 groups:LVEF≥0.50 is defined as ejection fraction re?served group, LVEF<0.50 is defined as the ejection fraction reduced group. Cys C, N terminal B-type natriuretic peptide (NT-proBNP), serum creatinine(Scr),UREA and Echocardiography were analyzed in all groups and their correlation was studied. Results Serum Cys C level in CHF patients was obviously higher than that in healthy controls, and it increased with NYHA heart function classification;compared with normal Cys C group,Cys C elevated group presented higher NT-proBNP level but lower eGFR and LVEF (P<0.05);compared with ejection fraction reduced group, ejection fraction reserved group demonstrated lower NT-proBNP, LVEDD, LVMI and Cys C levels (all P<0.05);Correlation analysis revealed that Cys C is correlated with age, NT-proBNP, LVEF, LVEDD, Scr and UREA (r=0.411, 0.658, 0.465, 0.310, 0.552, 0.486, P<0.01). Conclusion Serum Cys C can be used to evaluate cardiac function of heart failure, and is associated with ventricular remodeling.