血清肌钙蛋白I、N端前体脑钠肽和高敏C反应蛋白水平在充血性心力衰竭中的临床意义

目的：探讨血清肌钙蛋白I（cTnI）、N端前体脑钠肽（NT-proBNP）和高敏c反应蛋白（hs—CRP）水平在充血性心力衰竭（CHF）中的临床意义。方法：选取2010年1月-2012年12月在我院诊治的CHF患者210例（CHF组），心功能按纽约心脏病协会（NYHA）分级：Ⅱ级88例、Ⅲ级96例和Ⅳ级26例。同时选取同期在我院行健康体检的自愿者30例为健康对照组。观察和比较两组血清hs．CRP、cTnI和NT．proBNP水平的差异及其与CHF患者心功能的心功能分级的相关系。结果：CHF组患者的血清hs-CRP．cTnI和NT．proBNP水平均较对照组明显增高，差异均有统计学意义（P〈0．0t），且CHF患者的血清hs—CRP、cTnI和NT—proBNP水平随着心功能分级的增加而升高，差异有统计学意义（P〈0．01）。血浆hs—cI冲（F0．694，P〈0．01）水平，cTnI（r=0．782，P〈0．01）水平均与NT—proBNP水平呈显著正相关，血浆hs．CRP和cTnI水平也呈显著正相关（r==0．649，P〈0．01）。结论：CHF患者的血清hs—CRP、cTnI和NT-proBNP水平与其心功能分级显著相关，有助于评估CHF患者心功能不全的严重程度，可能与CHF患者的预后相关。

Clinical Significance of Serum Troponin I,N-terminal Pro-brain Natriuretic Peptide and High-sensitive C-reactive Protein Levels in the Congestive Heart Failure

Objective： To observe the clinical significance of serum Troponin I （cTnI）, N-terminal pro-brain natriuretic peptide （NT-proBNP） and high-sensitive C-reactive protein （hs-CRP） levels in congestive heart failure （CHF）. Methods： 210 patients with CHF, from January 2010 to December 2012, were subdivided into 88 cases in grade II, 96 cases in grade III and 26 cases in gradelV, according to the heart function classification of the New York Heart Association （NYHA）. At the same time 30 healthy volunteers as healthy control group were selected at the same period. The serum levels of cTnI, hs-CRPand and NT-proBNP were observed in each group. Results： The serum levels of hs-CRP, cTnI and NT-proBNP in CHF group were markedly increased compared with the healthy control group （P〈0.01）. The serum levels of hs-CRP, cTnI and NT-proBNP in patients with CHF increased as the heart function classification increased （P〈0.01）, the serum levels ofhs-CRP （r=0.694, P〈0.01） and cTnI （r=0.782, P〈0.01） was significantly positively correlated with NT-proB- NP, and the serum level of hs-CRP was positively correlated with cTnI （r=0.649, P〈0.01）. Conclusion： The serum hs-CRP, cTnI and NT-proBNP levels were significantly correlated with the degree of heart dysfimction of patients with CHF, which may contribute to eval- uate the severity of heart dysfunction and prognosis of patients with CHF.