血清胱抑素C在慢性心力衰竭早期诊断中的临床意义.doc

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1、血清胱抑素C在慢性心力衰竭早期诊断中的临床意义　　【摘要】目的分析血清胱抑素�β�性心力衰竭早期诊断的意义。方法106例住院患者，将患者分为对照组和病例组。对照组为既无器质性心脏病又无心力衰竭症状的患者，病例组包括既有器质性心脏病和心力衰竭症状的患者。对两组进行基线分析，采用Logistic单因素和多因素分析，确定CHF的独立危险因素。进行受试者工作特征曲线分析确定CysC作为CHF早期的评价指标的最佳界值。结果病例组患者的CysC水平mg/L，明显高于对照组患者的mg/L，差异有统计学意义。相关性分析发现，在单

2、因素分析中CysC在CHF早期诊断的OR值为17.701，说明CysC与CHF早期密切相关。调整相关影响因素后进行多因素Logistic回归分析，发现CysC无论是作为连续变量还是二分类变量，其都是CHF早期的重要危险因素，提示CysC可能是CHF早期的独立危险因素。通过ROC曲线获得CysC作为CHF早期诊断评价指标的最佳界点值是0.8850mg/L，灵敏度为77.5%，特异度为71.4%，结果说明此界值有较好的灵敏度和特异度。结论CysC是CHF的独立危险因素，对CHF早期诊断具有重要临床意义。　　【关键词】

3、慢性心力衰竭；血清胱抑素C；临床诊断　　DOI：10.14163/j.cnki.11-5547/r.2017.17.003　　ClinicalsignificanceofserumcystatinCinearlydiagnosisofchronicheartfailureTENGYan-chun，PANHong.ShenzhenCityBaoanDistrictFuyongPeople’sHospital，Shenzhen518100，China　　【Abstract】ObjectiveToanalyzesign

4、ificanceofserumcystatinCinearlydiagnosisofchronicheartfailure.MethodsAtotalof106hospitalizedpatientswererandomlydividedintocontrolgroupandcasegroup.Thecontrolgroupcontainedpatientswithoutorganicheartdiseaseandheartfailuresymptoms，andthecasegroupcontainedpatie

5、ntswithorganicheartdiseaseandheartfailuresymptoms.Bothgroupsreceivedbaselineanalysis.UnivariateandmultivariateLogisticanalysiswereappliedtodetermineindependentriskfactorforCHF.Receiveroperatingcharacteristiccurvewasusedtoanalyzeanddeterminethebestcut-offvalue

6、byCysCasearlyevaluationindexforCHF.ResultsThecasegrouphadobviouslyhigherCysClevelasmg/Lthanmg/Linthecontrolgroup，andtheirdifferencehadstatisticalsignificance.CorrelationanalysisshowedORvaluebyCysCas17.701inunivariateanalysisforearlydiagnosisofCHF，anditshowedc

7、losecorrelationbetweenCysCandearlyCHF.MultivariateLogisticanalysisafterregulationofrelatedinfluencingfactorsshowedCysC，actingascontinuousvariableorbinaryvariable，astheimportantriskfactorforearlyCHF.CysCwassuggestedastheindependentriskfactorforearlyCHF.ROCcurv

8、eshowedthatbestcut-offvalueas0.8850mg/LbyCysCasearlyevaluationindexforCHF，alongwithsensitivityas77.5%andspecificityas71.4%.Thecut-offvaluecontainedgoodsensitivityandspecificity.Conclusion