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目的探讨脑自然肽氨基端前体蛋白(NT-pro BNP)与超敏C反应蛋白(hs-CRP)在慢性心力衰竭患者病情分级中的应用价值,为慢性心力衰竭的早期诊断提供依据。方法选取2012年5月至2015年5月我院收治的慢性心力衰竭患者95例作为研究对象(病例组),按照病情分级不同又可分为心功能纽约分级(NYHA)Ⅰ级患者20例,NYHAⅡ级患者22例,NYHAⅢ级患者27例,NYHAⅣ级患者26例。另选取同期于我院进行健康检查的心功能正常人群32例作为对照组。应用SPSS 18.0统计软件对两组NT-pro BNP与hs-CRP水平进行统计学分析。结果病例组患者入院时NTpro BNP[(2 178.64±14.28)pg/ml]与hs-CRP水平[(8.43±2.94)mg/L]均明显高于对照组[分别为(120.58±35.72)pg/ml、(3.15±1.22)mg/L],差异均有统计学意义(P<0.05)。除NYHAⅠ级患者治疗前后NT-pro BNP与hs-CRP水平差异无统计学意义(P>0.05)外,其他病情分级患者治疗后NT-pro BNP与hs-CRP水平均明显低于治疗前,且病情分级程度越高,2指标水平越高,差异均有统计学意义(P<0.05)。随访中共有23例患者发生心血管事件(A组),72例患者未发生心血管事件(B组)。两组患者治疗后NT-pro BNP与hs-CRP水平均较治疗前明显下降。A组患者治疗前、后NT-pro BNP水平及治疗前hs-CRP均明显高于B组,差异均有统计学意义(P<0.05)。A组治疗后hs-CRP水平与B组比较。差异无统计学意义(P>0.05)。结论 NT-pro BNP与hs-CRP联合检测对于慢性心力衰竭病情分级及预后评估具有重要意义。
Objective To investigate the clinical value of NT-proBNP and hs-CRP in the classification of patients with chronic heart failure and provide evidence for the early diagnosis of chronic heart failure. Methods A total of 95 patients with chronic heart failure admitted to our hospital from May 2012 to May 2015 were selected as study subjects (case group). According to the different disease grades, they were divided into two groups: NYHA grade Ⅰ (n = 20) Twenty-two NYHA class Ⅱ patients, 27 NYHA class Ⅲ patients and 26 NYHA class Ⅳ patients. Another selected in our hospital for the same period in the normal cardiac function in 32 patients as a control group. The levels of NT-pro BNP and hs-CRP in two groups were statistically analyzed using SPSS 18.0 statistical software. Results Compared with the control group, the levels of NTpro BNP [(2 178.64 ± 14.28) pg / ml] and hs-CRP [(8.43 ± 2.94) mg / L] in hospital patients were significantly higher than those in the control group [(120.58 ± 35.72) pg / ml, (3.15 ± 1.22) mg / L], the difference was statistically significant (P <0.05). The levels of NT-pro BNP and hs-CRP in patients with other grading patients were significantly lower than those before treatment except NYHA class I patients with and without NT-pro BNP and hs-CRP levels (P> 0.05) The higher the grade of the disease, the higher the level of the 2 indicators, the differences were statistically significant (P <0.05). In the follow-up, 23 patients had a cardiovascular event (group A) and 72 patients did not have a cardiovascular event (group B). After treatment, the levels of NT-pro BNP and hs-CRP in both groups were significantly lower than those before treatment. The levels of NT-pro BNP and the hs-CRP before treatment in group A were significantly higher than those in group B before and after treatment, with significant differences (P <0.05). A group of hs-CRP levels after treatment compared with the B group. The difference was not statistically significant (P> 0.05). Conclusion The combined detection of NT-pro BNP and hs-CRP is of great significance in the evaluation of the grade of the patients with chronic heart failure and prognosis.