兰州大学机构库 >学院待认领
不同生物标记物在射血分数降低的心力衰竭与射血分数保留的心力衰竭中的对比研究
Alternative TitleComparative Differences in Biomarkers in Patients with Heart Failure with Reduced versus Preserved Ejection Fraction
张益铭
Thesis Advisor姚亚丽
2014-05-27
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword胱抑素C 高敏C反应蛋白 氮末端脑钠肽前体 射血分数保留的心力衰竭 射血分数降低的心力衰竭
Abstract目的 探讨氮末端脑钠肽前体(NT-proBNP)、高敏C反应蛋白(hs-CRP)、胱抑素C(cystatin C,CYSC)在射血分数降低的心力衰竭(HF-REF)与射血分数保留的心力衰竭(HF-PEF)中的表达水平及其之间的关系。 方法 选取于2012年11月~2013年5月就诊于兰大一院门诊的106例心力衰竭(HF)患者,58例HF-REF患者,48例HF-PEF患者。测定患者NT-pro BNP、CYSC、hs-CRP、肾功能、肝功、血脂、左室射血分数,比较分析两组中各指标之间的相关性。另选年龄、性别匹配的同期入院非心力衰竭患者50例为对照组。 结果 HF-REF患者的NT-proBNP、CYSC水平高于HF-PEF患者(P<0.05),hs-CRP在两组内没有明显差异(P>0.05),经过调整后,只有NT-proBNP在两组中有显著差异(P<0.01);HF-REF患者中:NT-pro BNP与hs-CRP及CYSC三者均具有相关性,NT-pro BNP与hs-CRP具有相关性(r=0.482, P =0.009<0.05),NT-pro BNP与CYSC具有相关性(r=0.450,P =0.014<0.05),hs-CRP与CYSC不具有相关性(r=0.338,P =0.079>0.05);HF-PEF患者中,NT-pro BNP只与CYSC具有相关性(r=0.429,P =0.041),hs-CRP与CYSC具有显著相关性(r= 0.834,P <0.001)。 结论: (1)心衰患者血管活性肽代偿增加,与HF-PEF相比,NT-proBNP在HF-REF中变化更为明显;(2)高敏C反应蛋白浓度及胱抑素C浓度在HF-REF与HF-PEF相似,二者不能区分HF-REF与HF-PEF;(3)生物标记物之间的相关性的差异表明,HF-PEF与HF-REF之间心衰标记物释放或者清除的机制可能存在潜在的显著差异,仍有待进一步研究。
Other AbstractObjective To compare the concentration of N-terminal proB-type natriuretic peptide (NT-pro BNP), high-sensitivity C-reactive protein (hs-CRP) and cystatin C (CysC) in patients with heart failure with reduced (HF-REF)versus preserved ejection fraction (HF-PEF), and to evaluate the relationship among these biomarkers in these two population. Methods 106 Out-patients with established diagnoses of heart failure were prospectively enrolled, including 58 HF-REF ( Group A) and 48 HF-PEF patients (Group B). We determined NT-proBNP, CysC, hs-CRP, renal function, liver function, blood fat, and left ventricular ejection fraction ( LVEF ) ,and compared concentrations of these biomarkers. Their relationship also was evaluated. Fifty patients matched with age and gender, who were not heart failure patients, were enrolled as the controls. Results Patients with HF-REF had significantly higher concentrations of NT-proBNP and cystatin C (both P<0.05),but similar concentrations of hs CRP(P>0.05). After adjusting for possible confounding variables, only concentrations of NT-proBNP remained significantly higher in patients with HF-REF compared with patients with HF-PEF( P<0.01). In patients with HF-REF, NT-proBNP correlated with hs-CRP(r=0.482,P=0.009<0.05),cystatin C (r=0.450,P=0.014<0.05),while hs-CRP was not correlated with cystatin C (r=0.338,P=0.079>0.05). In patients with HF-PEF, NT-pro BNP only correlated significantly with cystatin C(r=0.429,P=0.041<0.05), while hs-CRP correlated with cystatin C (r= 0.834,P<0.001). Conclusions: (1)Vasoactive peptide was compensatory increased in heart failure, the change of NT-proBNP is more obvious in HF-REF than HF-PEF;(2)Patients with HF-REF and HF-PEF presentsimilar concentrations of hsCRP and Cystatin C, these two biomarkers are unlikely to be useful to distinguish between HF-REF and HF-PEF;(3)The differences in the correlations between these biomarkers between these 2 populations suggest a potentially significant heterogeneity in the mechanisms involved in their release or clearance in HF-PEF compared with HF-REF,and need to be investigated further.
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/223782
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
张益铭. 不同生物标记物在射血分数降低的心力衰竭与射血分数保留的心力衰竭中的对比研究[D]. 兰州. 兰州大学,2014.
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