【摘要】 目的观察慢性心力衰竭患者在肾脏损害时血清胱抑素C(Cys-C)水平以及左室射血分数(LVEF)变化情况及其与心脏功能的关系,进一步明确Cys-C在慢性心力衰竭患者早期肾脏损害的诊断价值。方法测定31例心力衰竭患者、31例无心力衰竭的心脏病患者及29例健康对照者Cys-C、血清肌酐(Cr)、尿素氮(BUN)、尿微量白蛋白(MA)水平,并进行Cys-C与LVEF、MA等相关性分析。结果Cr、BUN正常的心力衰竭患者Cys-C、MA水平较无心力衰竭的心脏病患者和健康对照者明显增高[Cys-C(1.66±0.21)mg/L vs(1.28±0.40)mg/L、(1.03±0.39)mg/L,MA(89.8±58.4)mg/L vs(17.5±15.9)mg/L(、11.6±7.9)mg/L,均P<0.01];Cys-C与LVEF呈负相关(r=-0.42,P<0.01),Cys-C与MA呈正相关(r=0.39,P<0.01)。结论无原发性肾脏病变的慢性心力衰竭患者存在早期肾功能异常,主要表现为肾小球滤过功能受损;心力衰竭程度愈重,肾功能损害愈明显;Cys-C检测可用于慢性心力衰竭患者早期肾脏损害诊断。更多还原

【Abstract】 Objective To observe the changes of the cystatin C(Cys-C) in patients with chronic heart failure(CHF) and evaluate early impairment of renal function.Methods Serum cystatin C,blood creatinine,urea nitrogen and MA were measured in 31 patients with CHF,31 patients with cardiovascular diseases but compensated heart function and 29 normal volunteers.Results The levels of Cys-C and MA in CHF group were significantly higher than those in normal group and compensated heart function group,Cys-C(1.66±0.21) mg/L vs(1.28±0.40) mg/L and(1.03±0.39) mg/L,MA(89.8±58.4) mg/L vs(17.5±15.9) mg/L and(11.6±7.9) mg/L(P<0.01),respectively.Cys-C was negatively correlated with left ventricular ejection fraction(r=-0.42,P<0.01) and positively correlated with MA(r=0.39,P<0.01).Conclusion There is early abnormality of renal function in CHF patients without primary renal disorder and the abnormality was featured by impaired glomorular filtration function.The more severe the heart failure,the more significant the renal function impairment.Cys-C was a marker of early impairment of renal function in chronic heart failure.更多还原