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目的 观察慢性心肾综合征患者外周血肌钙蛋白Ⅰ (TnⅠ)、N末端脑钠肽原(NT-proBNP)、心脏脂肪酸结合蛋白(H-FABP)、肌红蛋白(MYO)水平变化,寻找慢性心肾综合征患者早期心脏损伤的生物标志物.方法 83例CKD患者,分为CKD 1 ～2期非CRS者28例(1组)、CKD 3 ～4期非CRS者14例(2组)、CKD 1 ～2期CRS者19例(3组)、CKD 3～4期CRS者22例(4组).另选同期我院20例健康体检者为对照组.采集各组空腹静脉血,检测各组外周血TnⅠ、NT-proBNP、MYO、H-FABP水平,计算H-FABP与MYO的浓度比值(F/M).检测各组肾功能及相关生化指标,观测各组心脏结构及功能.结果 对照组、1、2、3、4组外周血TnⅠ比较,P均＞0.05;对照组、1、2、3、4组外周血NT-proBNP分别为20、36、159、249、372 pg/mL,组间比较,P均＜0.05;2、3、4组MYO、H-FABP均高于1组及对照组,且2组均高于1组,4组均高于3组(P＜0.05);F/M在3、4高于1、2组及对照组(P＜0.05).结论 慢性心肾综合征患者外周血NT-proBNP、H-FABP、MYO水平升高,F/M升高.F/M受GFR的影响最小,可作为慢性心肾综合征的早期诊断指标.“,”Objective To observe the changes in levels of troponin Ⅰ (TnⅠ),N-terminal pro-brain natriuretic peptide (NT-proBNP),heart-type fatty acid-binding protein (H-FABP) and myoglobin (MYO) in patients with chronic cardiorenal syndrome (CRS) and to find their biological markers for early cardiac damage.Methods Eight-three patients with non-dialysis chronic kidney disease (CKD) were divided into 4 groups,including 28 patients with stage 1-2 CKD without cardiorenal syndrome in group 1,14 patients with stage 3-4 CKD without CRS in group 2,19 patients with stage 1-2 CKD with CRS in group 3,and 22 patients with stage 3-4 CKD with CRS in group 4.In addition,20 healthy individuals were used as the control group.Fasting venous blood was collected from each group the levels of TnⅠ,NT-proBNP,MYO and HFABP in peripheral blood were measured,and the concentration ratio between H-FABP and MYO (F/M) was calculated.The renal function and related biochemical indexes were detected,and the cardiac structure and function was observed.Results There was no significant difference in TnⅠ of the peripheral blood among these groups (all P ＞ 0.05).The NT-proBNP levels in the control group and groups 1,2,3 and 4 were 20,36,159,249 and 372 pg/mL,and significant difference was found between every two groups (all P ＜ 0.05).MYO and H-FABP in the groups 2,3 and 4 were higher than those in the group 1 and the control group,and group 2 was higher than group 1,group 4 was higher than group 3 (P ＜ 0.05).F/ M in the groups 3 and 4 was higher than that in the groups 1,2 and the control group (P ＜ 0.05).Conclusions NT-proB-NP,H-FABP,MYO levels and F/M increase in CKD patients with chronic CRS.Changes in renal function have little effect on the F/M ratio,therefore,the F/M ratio could be used as a marker for early cardiac damage in CKD patients.