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目的探讨慢性心力衰竭患者血浆视黄醇结合蛋白(RBP)、胱抑素(Cys-C)、NT-proB-NP浓度与体质量指数(BMI)的关系,及其对慢性心力衰竭患者心功能、预后评估的价值。方法 135例慢性心力衰竭患者(男70例,女65例,左心室射血分数<50%),测量患者身高、体重,根据BMI将患者分为三组:BMI正常组(BMI<24kg/m2)、超重组(BMI24～28kg/m2)及肥胖组(BMI>28kg/m2),测定慢性心力衰竭患者血浆RBP、Cys-C、NT-proBNP浓度,探讨其与BMI的相关性及其对慢性心力衰竭患者心功能、预后的影响。结果 (1)肥胖组患者血浆RBP水平[(70.45±8.74)mg/L]明显高于BMI正常组[(56.45±7.15)mg/L]及超重组[(64.61±7.24)mg/L],胱抑素水平[(2.78±0.38)mg/L]明显高于BMI正常组[(1.90±0.48)mg/L]及超重组[(2.39±0.41)mg/L],血浆NT-proBNP水平[(1536±69)ng/L]明显低于BMI正常组[(1857±145)ng/L]及超重组[(1726±115)ng/L](P均<0.01);(2)慢性心力衰竭患者血浆RBP、Cys-C与BMI之间存在显著正相关(r=0.621,P<0.01;r=0.680,P<0.01),且随肥胖程度加重而逐渐增高;NT-proBNP与BMI之间存在显著负相关(r=-0.865,P<0.01)。结论慢性心力衰竭患者血浆RBP、Cys-C水平均随BMI增加而增加,而NT-proBNP随BMI增加而降低,联合检测血浆NT-proBNP、Cys-C、RBP水平有利于肥胖合并慢性心力衰竭的诊断及预后评估。
Objective To investigate the relationship between plasma concentration of retinol-binding protein (RBP), cystatin C (NT-proB-NP) and body mass index (BMI) in patients with chronic heart failure , The value of prognosis assessment. Methods 135 patients with chronic heart failure (70 males and 65 females, left ventricular ejection fraction <50%) were enrolled. The height and weight of the patients were measured. The patients were divided into three groups according to BMI: normal BMI group , BMI24 ~ 28kg / m2) and obesity group (BMI> 28kg / m2), the levels of plasma RBP, Cys-C and NT-proBNP in patients with chronic heart failure were measured to explore its correlation with BMI and its effect on chronic Impact of Heart Function and Prognosis on Patients with Heart Failure. Results The level of RBP in obese patients was significantly higher than that in normal controls ([(70.45 ± 8.74) mg / L vs [56.45 ± 7.15 mg / L] and [64.61 ± 7.24 mg / L] The level of cystatin was significantly higher than that in the normal BMI group [(1.90 ± 0.48) mg / L vs [2.39 ± 0.41 mg / L] and [2.78 ± 0.38 mg / L] (1536 ± 69) ng / L] were significantly lower than those in normal BMI group [(1857 ± 145) ng / L and [1726 ± 115] ng / L] There was a significant positive correlation between plasma RBP, Cys-C and BMI in patients with failure (r = 0.621, P <0.01; r = 0.680, P <0.01), and gradually increased with the increase of obesity. There was a significant negative correlation (r = -0.865, P <0.01). Conclusions The levels of plasma RBP and Cys-C in patients with chronic heart failure increase with the increase of BMI, while NT-proBNP decreases with the increase of BMI. Combined detection of plasma NT-proBNP, Cys-C and RBP levels is beneficial for obesity with chronic heart failure Diagnosis and prognosis assessment.