血清胱抑素C与慢性心功能不全严重程度的相关性
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A Correlation Study Between Serum Cystatin C and the Severity of Chronic Heart Failure
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    目的 分析血清胱抑素C水平与慢性心功能不全(CHF)严重程度的相关性。方法 连续入选中国医科大学附属盛京医院心内科2009年2月~2012年1月因CHF住院患者925例,使用SPSS 17.0软件建立数据库并进行统计分析,采用单向方差分析、χ2检验及Logistic分析观察胱抑素C水平与患者心功能不全严重程度的关系;并通过受试者工作特征曲线(ROC曲线)确定胱抑素C作为中、重度心功能不全的评价指标的最佳界值。结果 心功能Ⅱ、Ⅲ、Ⅳ级,胱抑素C浓度分别为1.22±0.62、1.56±0.91、1.72±1.00 mg/L,组间比较差异有统计学意义(P<0.01);多因素Logistic分析中,调整了多种潜在影响因素后,胱抑素C作为连续变量时OR值为2.087(95%CI:1.125~3.874),作为二分类变量时OR值为2.335(95%CI:1.243~4.385)。通过ROC曲线获得胱抑素C作为中、重度心功能不全的评价指标的最佳界值为1.37 mg/L,灵敏度为95%的界值是0.77 mg/L,特异度为95%的界值是2.57 mg/L。结论 胱抑素C是评价CHF患者心功能严重程度的独立危险因素,对于CHF患者,胱抑素C作为中、重度心功能不全的评价指标的最佳界值为1.37 mg/L。

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    Aim To explore the correlation between cystatin C (Cys C) and the severity of chronic heart failure (CHF). Methods We selected 925 patients with CHF hospitalized in Shengjing Hospital of China Medical University between February 2009 and January 2012. The database was created and analyzed with SPSS software version 17.0. We analyzed the relativity between Cys C and the severity of CHF with one-way analysis of variance, χ2 inspection and Logistic analysis and decided the best critical value of Cys C used as the reference index of moderate and severe cardiac dysfunction with receiver operating characteristic curve (ROC curve). Results For patients with functional class II-IV [New York Heart Association (NYHA)], the density of Cys C is 1.22±0.62, 1.56±0.91, 1.72±1.00 mg/L separately, there is statistical significance in group comparison (P<0.01) in multifactor Logistic analysis, after adjusting many potential influential factors, the OR of Cys C is 2.087 (95%CI: 1.125-3.874) when it is a continuous variable, and 2.335 (95%CI: 1.243-4.385) when it is a binary variable. The best critical value of Cys C used as the reference index of moderate and severe cardiac dysfunction is 1.37 mg/L, when the sensitivity is 95%, the critical value is 0.77 mg/L, when the specificity is 95%, it is 2.57 mg/L. Conclusion The Cys C is an independent risk factor to evaluate the severity of cardiac dysfunction and for patients with CHF, the best critical value of Cys C used as the reference index of moderate and severe cardiac dysfunction is 1.37 mg/L.

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王传合,常 冶,郑黎强,王 力,司兵兵,董玲玲,孟庆坤,韩 苏,孙兆靑,孙志军.血清胱抑素C与慢性心功能不全严重程度的相关性[J].中国动脉硬化杂志,2014,22(02):181~185.

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  • 收稿日期:2013-11-01
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