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目的探讨慢性心力衰竭患者血清中NGAL和APN水平与患者心功能分级的关系,明确两者和心血管事件的预测价值。方法选取2014年5月-2015年5月在本院就诊的慢性心力衰竭的128例患者作研究对象,根据心功能分级分为I级(50例)、Ⅱ级(36例)、Ⅲ级(30例)和Ⅳ级组(12例),检测患者血清中NGAL和APN水平,根据中位数将患者分为NGAL高水平组(64例)、NGAL低水平组(64例)和APN高水平组(64例)、APN低水平组(64例),分析患者血清中NGAL和APN水平对患者心血管事件的预测价值。结果 APN、NGAL高水平组中,心功能Ⅳ级和Ⅲ级的患者多于低水平组,而Ⅰ级和Ⅱ级的患者少于低水平组,差异均有统计学意义(P<0.05)。APN高水平组、NAGL高水平组的患者LVEF低于对应低水平的患者,而LVEDP、RVEDP、m PAP则高于对应低水平的患者,差异均有统计学意义(P<0.05)。多因素分析结果提示,LVEF、NGAL、ANP是患者心血管事件的独立风险因素。结论 APN和NGAL与CRF患者病情密切相关,是患者心血管事件发生的独立危险因素。
Objective To investigate the relationship between the level of NGAL and APN in patients with chronic heart failure and the grading of cardiac function in patients with chronic heart failure and to determine the predictive value of both of them and cardiovascular events. Methods A total of 128 patients with chronic heart failure admitted to our hospital from May 2014 to May 2015 were enrolled in this study. According to their cardiac function, they were divided into two groups: grade I (50 cases), grade Ⅱ (36 cases), grade Ⅲ (N = 30) and grade Ⅳ (n = 12). The serum levels of NGAL and APN in patients were detected. According to the median, patients were divided into NGAL high level group (64 cases), NGAL low level group (64 cases) and APN low-level group (64 cases). The predictive value of NGAL and APN in patients’ serum on cardiovascular events were analyzed. Results In APN and NGAL high level group, the patients with grade Ⅳ and Ⅲ of cardiac function were more than the low level group, while the patients of grade Ⅰ and Ⅱ were less than the low level group, the difference was statistically significant (P <0.05). LVEF in patients with APN high level and NAGL high level group was lower than those with corresponding low level, while LVEDP, RVEDP and m PAP were higher than corresponding low level patients (P <0.05). Multivariate analysis suggested that LVEF, NGAL and ANP were independent risk factors for cardiovascular events in patients. Conclusion APN and NGAL are closely related to CRF and are independent risk factors for cardiovascular events.