心衰患者血清胱抑素C、嗜铬粒蛋白A与心室重构的关系

目的: 研究慢性心力衰竭(CHF) 患者血清胱抑素 C（Cys C）、嗜铬粒蛋白A（CgA）与心室重构的相关性。方法:选取因心衰住院治疗的患者共80例，其中心功能Ⅱ级组30例、Ⅲ级组30例和Ⅳ级组20例，正常体检者20例设为对照。测定血清Cys C、CgA水平、N端-B型利钠肽原( NT-proBNP)，经胸超声心动图测量左室射血分数（LVEF）、左房内径(LAD) 、左室舒张末内径(LVEDD) 、左室舒张末容积(LVEDV) 、计算左室质量指数(LVMI) 。结果:(1) CHF患者中Cys C和CgA水平均较正常对照组增高并且心功能Ⅳ级高于Ⅲ级；Ⅲ级高于Ⅱ级；Ⅳ级高于Ⅱ级。(2)血清Cys C和CgA存在正相关关系。(3) CHF患者中Cys C 和CgA水平与 LAD、LVD、LVMI、 NT-proBNP 呈正相关，与LVEF呈负相关。结论:Cys C 、CgA水平与心衰患者心室重构及心功能具有相关性，可做为衡量 CHF 患者心室重构程度的一项指标。

Relationship between the serum cystatin C,chromaffin grain protein A and the ventricular remodeling in patients with chronic heart failure

Objective: To study the correlation between serum cystatin C , chromaffin grain protein A (CgA) and the ventricular remodeling in patients with chronic heart failure (CHF). Methods: Eighty cases of hospitalized CHF patients were enrolled in the study , with 30 cases in NYHA Class Ⅱ , 30 cases in NYHA Class Ⅲ , 20 cases in NYHA Class Ⅳ and 20 casesnormal physical examination as control. Serum Cys C, CgA ,NT –proBNP, left ventricular ejection fraction (LVEF), left atrial diameter(LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume (LVEDV), left ventricular, left ventricular mass index (LVMI) were measured by echocardiography. Results: (1) CysC and CgA levels were higher in CHF patients than normal control group and NYHA Class Ⅳ higher than Class Ⅲ; NYHA Class Ⅲ level higher than Class Ⅱ level; Class Ⅳ level higher than Ⅱ level.(2) Serum Cys C and CgA had positive correlation.3 Cys C and CgA levels in patients with CHF and LAD, LVD, LVPWT, IVST, LVMI, NT-proBNP were positively correlated, and negatively correlated with LVEF. (3) Cys C and CgA levels in patients were positively correlated with CHF and LAD, LVD, LVMI, NT-proBNP, and negatively correlated with LVEF. Conclusion: The level of Cys C, CgA are correlated with ventricular remodeling and cardiac function in CHF patients, and they can be used as a indicator to determine the degree of ventricular remodeling in CHF patients.