C反应蛋白与慢性心力衰竭患者心功能的关系

摘要

目的:探讨血清C反应蛋白(CRP)与慢性心力衰竭(CHF)患者心功能的关系.方法:选择76例CHF患者根据纽约心脏病协会(NYHA)分级分为:NYHAⅡ级组20例,NYHAⅢ级组30例,NYHAⅣ级组26例,另选择40例心脏功能正常者为正常对照组.采用免疫比浊法测定各组血清CRP水平,同时应用超声心动图测定左心室射血分数(LVEF).结果:与正常对照组比较,心功能NYHAⅡ～Ⅳ级患者血清CRP水平明显升高[(2.46±1.26)mg/ml比(5.33±1.07)mg/ml比(12.11±0.31)mg/ml比(19.12±1.35)mg/ml],LVEF[(0.65±0.13)比(0.46±0.15)比(0.40±0.12)比(0.35±0.20)]明显降低(P均＜0.01);直线相关分析提示CRP水平与NYHA分级数呈正相关(r=0.817,P＜0.01).结论:血清C反应蛋白与NYHA分级数呈正相关,能反映心功能恶化程度,是判断慢性心力衰竭的指标.%Objective: To investigate relationship between serum C- reactive protein (CRP) and cardiac function in patients with chronic heart failure (CHF). Methods: According to New York heart association (NYHA) cardiac function classification, a total of 76 CHF patients were divided into NYHA class Ⅱ group (n= 20), NYHA class Ⅲ group (n = 30) and NYHA class Ⅳ group (n = 26). Another 40 subjects with normal cardiac function were enrolled as normal control group. Immunoturbidimetry was used to measure CRP level and echocardiography was used to measure left ventricular ejection fraction (LVEF) in all groups. Results: Compared with normal control group, there were significant increase in serum level of CRP [ (2.46 ± 1.26) mg/ml vs. (5.33 ± 1. 07) mg/ml vs. (12.11 ± 0. 31) mg/ml vs. (19.12 ± 1. 35) mg/ml] and significant decrease in LVEF [ (0. 65 ± 0.13) vs. (0. 46 ± 0.15) vs. (0.40 ± 0.12) vs. (0. 35 ± 0.20)] in NYHA II, i and IV group, P<0.01 all; linear correlation analysis indicated that CRP level was positively correlated with NYHA class (r = 0.817, P<0.01). Conclusion: Serum level of C reactive protein is positively correlated with NYHA class, can reflect deterioration of cardiac function, and can be an index evaluating chronic heart failure.