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目的探讨老年慢性心力衰竭患者不同美国纽约心脏病学会(NYHA)心功能分级与血清学指标的相关性。方法选择2014年5月-2015年5月在新疆医科大学第一附属医院心脏中心心力衰竭科接受治疗的90例老年慢性心力衰竭患者为研究对象,并根据其NYHA心功能分级的不同分为Ⅰ/Ⅱ级组(26例)、Ⅲ级组(35例)和Ⅳ级组(29例),同时选取30例健康老年人作为对照组。观察各组患者的一般临床资料和血清学指标的差异;分析老年慢性心力衰竭患者心功能不全的危险因素,以及心功能分级与血清学指标的相关性。结果 4组患者舒张压水平无明显差异,而4组患者间的体质指数(BMI)、收缩压、总胆固醇、甘油三酯、低密度脂蛋白(LDL)、N端前脑钠肽(NTproBNP)、高敏C反应蛋白(hs-CRP)和糖类抗原125(CA125)差异均有统计学意义,且心功能Ⅳ级组>心功能Ⅲ级组>心功能Ⅰ/Ⅱ级组>对照组;而4组患者的高密度脂蛋白(HDL)水平:心功能Ⅳ级组<心功能Ⅲ级组<心功能Ⅰ/Ⅱ级组<对照组;吸烟史、高密度脂蛋白(HDL)、N端前脑钠肽(NTproBNP)、hs-CRP和CA125水平是老年慢性心力衰竭患者心功能不全的影响因素(P<0.05);老年慢性心力衰竭患者的心功能分级与NTproBNP、hs-CRP和CA125水平呈正相关。结论老年慢性心力衰竭患者的血脂水平及NTproBNP等血清血指标较高,且与患者的心功能分级呈正相关。
Objective To investigate the correlation between NYHA cardiac function and serological parameters in elderly patients with chronic heart failure. Methods From May 2014 to May 2015, 90 elderly patients with chronic heart failure undergoing heart failure in the Heart Center of the First Affiliated Hospital of Xinjiang Medical University were enrolled in this study. According to their NYHA classifications, / Grade Ⅱ group (26 cases), grade Ⅲ group (35 cases) and grade Ⅳ group (29 cases). 30 healthy elderly people were selected as the control group. To observe the difference of general clinical data and serological indexes of patients in each group; to analyze the risk factors of heart failure in elderly patients with chronic heart failure, and the correlation between the grade of cardiac function and serum indexes. Results There was no significant difference in diastolic blood pressure between the four groups. BMI, systolic blood pressure, total cholesterol, triglyceride, low density lipoprotein (LDL), N-terminal pro-brain natriuretic peptide (NTproBNP) (Hs-CRP) and carbohydrate antigen 125 (CA125) were significantly different between the two groups, and there was significant difference in the level of cardiac function Ⅳ, cardiac function Ⅲ, cardiac function Ⅰ / Ⅱ, and control group. The levels of HDL in the four groups were as follows: heart function Ⅳ group, heart function Ⅲ group heart function Ⅰ / Ⅱ group control group, smoking history, high density lipoprotein (HDL), N-terminal The levels of NTproBNP, hs-CRP and CA125 were the influencing factors of heart failure in elderly patients with chronic heart failure (P <0.05). The heart function scores of elderly patients with chronic heart failure were positively correlated with the levels of NTproBNP, hs-CRP and CA125 Related. Conclusion Serum lipids, NTproBNP and other serum markers are higher in elderly patients with chronic heart failure and are positively correlated with the grading of cardiac function.