| Objective:The correlation between Homocysteine(Hcy),Cystatin C(Cys-C),Red blood cell distribution width(RDW)levels and clinical indicators and Chronic heart failure(CHF)cardiac function severity was analyzed retrospectively,and the value in prognosis was evaluated.In addition,it provides new ideas for early prevention,disease evaluation and prognosis improvement of CHF patients.Methods:A total of 45 healthy people who underwent physical examination in our hospital from January 2017 to September 2019 were collected as the healthy control group,and 147 patients with chronic heart failure who were admitted to the department of cardiology of our hospital during the same period and included in strict accordance with inclusion/exclusion criteria were included in the heart failure(CHF)group.According to the New York heart association(NYHA)cardiac function classification standard,in patients with chronic heart failure can be divided into 3 groups,respectively NYHAII level group,the levels NYHAIII group and NYHAIV group,recorded in each group respectively the research object of general information,including gender,age,history of smoking,drinking,history of hypertension,diabetes,body mass index(body mass index,BMI).Records in the hospital 24 hours of measured b-type natriuretic peptide(BNP),blood homocysteine(Hcy),serum(inhibition C(Cys-C),red blood cell volume distribution width(RDW)and hospital stay had done heart echocardiography of left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF)and other clinical and laboratory data.All patients were followed up for 6 months after discharge,and the number of patients who were re-hospitalized for heart failure or died of cardiovascular diseases within 6 months was recorded.The general clinical data of the observed subjects were compared,and the correlation between blood Hcy,Cys-C,RDW and BNP was analyzed.Risk factors for rehospitalization or death at 6 months were analyzed by logistic regression.ROC was used to predict the value of BNP,Hcy,Cys-C and RDW for 6 months of rehospitalization or death in patients with CHF.Results:1.The age,BMI,LVEF,LVEDd and BNP of the four groups were compared,andthe differences were statistically significant(all P<0.05).The differences ofLVEDd,BNP and LVEF between the two groups were statistically significant(all P<0.05).2.Comparison of Hcy,Cys-C and RDW in blood of patients in each groupshowed that cardiac function grading increased,while Hcy and RDW graduallyincreased,with statistically significant differences(P<0.05).There was nosignificant difference in Cys-C(P>0.05).3.There was a positive correlation between Hcy,RDW and BNP in each group(r>0,P<0.05).The correlation between serum Cys-C and BNP was not strong,and the results were not statistically significant(P>0.05).4.Among CHF patients,those who were re-hospitalized or died at 6 months wereof higher age,lower LVEF,higher BNP and higher RDW,with statisticallysignificant differences(all P<0.05).Age and LVEF were independent riskfactors for rehospitalization or death at 6 months.5.The efficacy of Hcy,Cys-C,RDW and BNP in the detection and diagnosis ofCHF patients at 6 months 'hospitalization or death,the results showed that allthe four indicators had diagnostic value,and the difference was not statisticallysignificant(P>0.05).There was no statistically significant difference betweenthe combined detection of Hcy,Cys-C and RDW under the ROC curve and theseparate detection of BNP(P>0.05).Conclusion:1.The Hcy and RDW levels of CHF patients showed an upward trend with thedecline of NYHA cardiac function classification,and were positively correlatedwith BNP level,suggesting that the above two indicators may have certainguiding significance for the diagnosis of chronic heart failure and theassessment of the severity of the disease.2.Through the ROC curve analysis of Hcy,Cys-C,RDW and BNP detectiondiagnosis in patients with CHF six months longer hospitalization or death ofeffectiveness,results show that the four indicators have diagnostic value,andthere was no statistically significant difference,the joint detection of Hcy,Cys-C and RDW area under the ROC curve and the difference between the BNPtesting alone is small,suggest that joint detection can be helpful to judge theprognosis of patients with heart failure. |
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