Xue Chuncai, Feng Ying, Wo Jinshan, Li Yigang
Department of Cardiology, The People's Hospital of Binzhou City. Binzhou City, 256610, Shandong, China.
N Z Med J. 2006 Nov 17;119(1245):U2314.
To determine whether high-sensitivity C-reactive protein (hsCRP) has prognostic value in patients with chronic heart failure.
Serum hsCRP levels were measured with high-sensitivity assay (IMMAGE Immunochemistry Systems) in 128 patients with CHF and 25 healthy control subjects. Cardiac troponin T (TNT) was measured by electrochemiluminescence immunoassay on an Elecsys1010 automatic analyser. Cardiac events were defined as cardiac death and rehospitalisation because of worsening heart failure during the follow-up period.
Circulating levels of hsCRP and TNT were significantly higher in patients with CHF than in the 25 healthy people (p=0.0028, p=0.017, respectively) and increased with severity of CHF. During a mean follow-up period of 378 +/- 26 days, 42 (32.8%) of the 128 patients had cardiac events. Levels of hsCRP and TNT were significantly higher (p=0.00031, p=0.00047, respectively) and LVEF was significantly lower (p=0.0052) in patients with cardiac events than in patients without cardiac events. When multivariate Cox proportional hazards regression was performed, we found that hsCRP, TNT, and LVEF were independent significant predictors of cardiac events in patients with CHF (hsCRP: hazard ratio [HR], 3.81; 95% confidence interval [CI], 2.14-9.35; p=0.024; TNT: HR, 2.61; 95%CI, 1.96-4.31; p=0.012; LVEF: HR, 3.52; 95%CI, 2.36-10.37; p=0.024). When Pearson's correlation analyses were performed, we could find a positive correlation between hsCRP and TNT (r=0.493, p=0.0043) and a negative correlation between hsCRP and LVEF(r=-0.354, p=0.0051).
Serum hsCRP concentrations were elevated in patients with CHF and increased with severity of CHF. It was an independent significant predictor of cardiac events in patients with CHF.
确定高敏C反应蛋白（hsCRP）在慢性心力衰竭患者中是否具有预后价值。
采用高敏检测法（IMMAGE免疫化学系统）检测128例慢性心力衰竭（CHF）患者和25例健康对照者的血清hsCRP水平。采用电化学发光免疫分析法在Elecsys1010自动分析仪上检测心肌肌钙蛋白T（TNT）。心脏事件定义为随访期间因心力衰竭恶化导致的心脏死亡和再次住院。
CHF患者的hsCRP和TNT循环水平显著高于25例健康人（分别为p = 0.0028，p = 0.017），且随CHF严重程度增加而升高。在平均随访378±26天期间，128例患者中有42例（32.8%）发生心脏事件。发生心脏事件的患者hsCRP和TNT水平显著更高（分别为p = 0.00031，p = 0.00047），左心室射血分数（LVEF）显著更低（p = 0.0052）。进行多变量Cox比例风险回归分析时，我们发现hsCRP、TNT和LVEF是CHF患者心脏事件的独立显著预测因素（hsCRP：风险比[HR]，3.81；95%置信区间[CI]，2.14 - 9.35；p = 0.024；TNT：HR，2.61；95%CI，1.96 - 4.31；p = 0.012；LVEF：HR，3.52；95%CI，2.36 - 10.37；p = 0.024）。进行Pearson相关分析时，我们发现hsCRP与TNT呈正相关（r = 0.493，p = 0.0043），hsCRP与LVEF呈负相关（r = -0.354，p = 0.0051）。
CHF患者血清hsCRP浓度升高，且随CHF严重程度增加而升高。它是CHF患者心脏事件的独立显著预测因素。
