| Objective: To study the correlation between serum CysC and the severity of heart failure in patients with coronary heart disease(CHD),so as to provide some reference value for clinical evaluation of the severity of heart failure.Methods: In this study,91 patients admitted to the Affiliated Hospital of Yan 'an University from September 2018 to December 2019 with coronary heart disease and heart failure,were selected as the heart failure group.The diagnosis standard of coronary heart disease(CHD)was in accordance with the 8th edition of internal medicine textbook of the people's Health Press.The diagnosis standard of heart failure was in accordance with the 2018 China heart failure diagnosis and treatment guidelines.At the same time,80 CHD patients in our hospital and 80 healthy people in our physical examination center were selected as the control group.According to NYHA heart function classification,the heart failure group was divided into three groups: level ?(n = 34),level ?(n = 30)and level ?(n = 27).After all the subjects came to the hospital,they carefully inquired about age,smoking history,drinking history,etal.and measured blood pressure,measured height and weight,and obtained body mass index(BMI).Meanwhile,the elbow vein blood was used to test the serum CysC,pro-BNP and other laboratory indexes.In addition,the experienced B-mode ultrasound doctors in our hospital performed Doppler echocardiography,and the detection method was in line with the method recommended by the World Health Organization and the international Heart Federation.Left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were measured by M-mode ultrasound.Compared the general data and clinical data of the control group,coronary heart disease group and CHD group with heart failure,observed whether there was statistical difference in CysC and pro-BNP among the three groups;According to the NYHA heart function classification group,compared the clinical data of the three subgroups,observed whether there was statistical difference in CysC and pro-BNP among the three groups;analyzed the correlation between CysC and pro-BNP,LVEF,LEVDD and NYHA classification;The risk factors of the severity of chronic heart failure after coronary heart disease were screened by logistic regression.All data were analyzed by spss22.0.Results:1.Comparison of general data between the control group and CHD group,CHD combined with heart failure group.There was no difference among the three groups in gender,age,BMI,heart rate,smoking history,drinking history,etc.(P > 0.05).2.Comparison of clinical data among the control group,the CHD group and the CHD group with heart failureThere were no statistically differences among the three groups in the aspects of excretion,CRE,TG,TC,AST and ALT(p > 0.05).However,the differences among pro-BNP(537±38.99,576.92±40.02,3474.24±727.80),CysC(0.51±0.21,0.79±0.24,1.30±0.41),LVEF(66.70±3.43,59.90±5.16,51.95±8.20)and LVEDD(44.19±3.58,49.6±5.06,59.79±7.94)were statistically significant(p < 0.05).3.The comparison of clinical data among the three groups of cardiac function(level?,level ? and level ?)The difference of Pro-BNP among the three groups of cardiac function(level ?,level ? and level ?)(1226.22 ± 340.38,3266.40 ± 1643.73,6535.99 ± 2490.59)was statistically significant(P < 0.05).With the increase of cardiac function,the level of Pro-BNP gradually increased,and there was statistically significant difference between the two groups(P < 0.05);There was a significant difference in serum CysC(1.10 ±0.27,1.38 ± 0.37,1.46 ± 0.49)among the three groups(P < 0.05).With the increase of cardiac function,the level of serum CysC is higher and higher,and there was a significant difference between the two groups(P < 0.05);Compared with LVEF(57.29 ±5.60,47.27 ± 6.03,39.33 ± 4.27),the difference was statistically significant(P < 0.05),and with the increase of cardiac function,the level of LVEF decreased gradually,and there was statistical significance after the comparison between the two groups(P < 0.05);The difference in LEVDD was statistically significant among the three groups of level II,III and IV of cardiac function(54.59 ± 6.09,60.17 ± 6.98,65.93 ± 6.49),(P < 0.05),and with the increase of cardiac function,the level of LEVDD increased gradually,and there was statistically significant difference between the two groups(P < 0.05).4.Correlation analysis of serum CysC with Pro-BNP,LVEF,LEVDD and NYHA gradesThere was a positive correlation(r = 0.633,r = 0.491,rs = 0.794,P < 0.05)between CysC and pro-BNP,LVEDD,NYHA,and a negative correlation(r =-0.711,P < 0.05)with LVEF.5.In the logistic regression analysis of the factors related to the severity of coronary heart disease with heart failureThe functional classification of coronary heart disease with heart failure was taken as the corresponding variable,and the clinical data were taken as the independent variables.Pro-BNP,CysC and LVEF were selected as the independent risk factors affecting the severity of coronary heart disease with heart failure.Conclusion: 1.The expression of serum CysC in patients with coronary heart disease and heart failure is higher than that in patients with simple coronary heart disease and normal people;2.There is a correlation between serum CysC and the severity of coronary heart disease and heart failure,with the increase of heart function,serum CysC gradually increases;3.Serum CysC is a risk factor and an independent risk factor affecting the severity of coronary heart disease and heart failure;4.Serum CysC can assist in assessing the severity of coronary heart disease with heart failure. |
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