血清胱抑素C与肌酐在评估75岁以上老年慢性心衰患者预后中的价值

发布时间：2018-04-22 13:49

  本文选题：慢性心脏功能衰竭 + 胱抑素C　； 参考：《西安交通大学学报(医学版)》2017年01期

【摘要】：目的比较血清胱抑素C(cystatin-C,Cys-C)和肌酐(creatinine,Cr)对评估老年慢性心脏功能衰竭(chronic heart failure,CHF)患者预后的价值。方法收集我院心内科及老年科2010-2012年住院确诊为CHF的75岁以上老年患者183例。抽取静脉血,检测所有患者血清中Cys-C和Cr的表达情况。随访3年,记录患者3年内生存情况。Logistic回归分析Cys-C和Cr以及其他危险因素与老年CHF患者3年死亡率的相关性。ROC曲线分析比较Cys-C和Cr在老年CHF患者预后评估中的价值,最后进一步用统计学方法分析Cys-C和Cr二者联合检测对老年CHF患者预后评估的价值。结果随访3年后,74名患者死亡,占整体人数的40.44%;相比于生存组,死亡组患者血清中Cys-C和Cr升高(P0.05);多因素回归结果显示,年龄(OR=1.11,95%CI=1.04~1.19)、收缩压值(OR=1.11,95%CI=1.04~1.19)、BNP(OR=1.11,95%CI=1.04~1.19)、LVEF(OR=1.11,95%CI=1.04~1.19)、Cr(OR=1.11,95%CI=1.04~1.19)、Cys-C(OR=1.11,95%CI=1.04~1.19)都是老年CHF患者死亡的独立危险因素。ROC曲线分析结果显示,Cys-C和Cr的AUC值分别为0.71(95%CI,0.64~0.78)、0.65(95%CI,0.58~0.72),Cys-C优于Cr(P0.001);Cys-CCr联合检测时,AUC值为0.73(95%CI,0.66~0.79)。结论 Cys-C在评估老年CHF患者预后中优于Cr,两者联合检测可以进一步提升对老年CHF患者预后评估的敏感性和特异性。
[Abstract]:Objective to compare the value of serum cystatin cystatin C and creatinine creatinine Cr in evaluating the prognosis of elderly patients with chronic heart failure. Methods 183 patients over 75 years old who were diagnosed as CHF in Department of Cardiology and Geriatrics from 2010 to 2012 were collected. The expression of Cys-C and Cr in the serum of all patients was detected. After 3 years follow-up, the prognostic value of Cys-C and Cr in elderly patients with CHF was compared by logistic regression analysis with Cys-C, Cr and other risk factors. Finally, the value of combined detection of Cys-C and Cr in elderly patients with CHF was analyzed by statistical method. Results after 3 years follow-up, 74 patients died, accounting for 40.44% of the total; compared with the survival group, the serum Cys-C and Cr in the dead group increased P0.05.The multivariate regression analysis showed that, 骞撮緞(OR=1.11,95%CI=1.04~1.19),鏀剁缉鍘嬪，

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