慢性充血性心力衰竭患者血浆β2微球蛋白变化的临床分析(1)
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[摘要] 目的：探讨慢性充血性心力衰竭严重程度与早期肾损害的相关性。方法：选择2010年1月~2011年8月于我院心内科病房住院的慢性充血性心力衰竭患者92例，按纽约心脏病学会(NYHA)心功能分级将全部患者分为三组，A组32例， NYHA Ⅱ级；B组30例，NYHA Ⅲ级；C组30例， NYHA Ⅳ级。全部患者入院后均给予β2微球蛋白、心电图、肝肾功能、血脂、血糖、N端B型脑钠肽(NT-BNP)、肌酸激酶同功酶、肌钙蛋白、心脏彩超的检测。结果：A、B、C三组随着心功能分级的上升，左心室舒张末期前后径(LVDD)、左心室收缩末期前后径(LVESD)亦随之增大，左心室射血分数(LVEF)降低， NT-BNP、血β2微球蛋白浓度升高，差异均有统计学意义(P<0.05)。结论：随着心功能不全加重，血β2微球蛋白浓度升高，在诊疗慢性心功能不全患者时，要注意避免使用损害肾脏功能的药物。
[关键词] 慢性充血性心力衰竭；血浆β2微球蛋白；N端B型脑钠肽；心脏彩超
[中图分类号] R541.61 [文献标识码] A [文章编号] 1673-7210(2011)12(a)-060-02
Clinical analysis of plasma β2-microglobulin concentrations in patients with chronic congestive heart failure
HAN Zhongyuan
Department of Cardiology, the Second People＇s Hospital of Nantong City, Jiangsu Province 226002, China
[Abstract] Objective: To investigate the association between the severity of chronic congestive heart failure (CHF) and early renal injury. Methods: 92 cases of patients with CHF in cardiology department of our hospital from January 2010 to August 2011 were selected. Based on New York Heart Association (NYHA) grading criterion, all patients were divided into three groups. There were 32 cases in group A with NYHA of Ⅱ grade, 30 cases in group B with NYHA of Ⅲ grade, and 30 cases in group C with NYHA of Ⅳ grade. Plasma β2-microglobulin concentrations, plasma NT-proBNP concentrations, liver and kidney function, blood lipid, blood sugar, creatine kinase MB, troponin and electrocardiogram, echocardiography were determined. Results: Left ventricular diastolic dimension (LVDD), left ventricular end systolic diameter (LVESD) were magnified, plasma NT-proBNP concentrations and plasma β2-microglobulin concentrations were raised and left ventricular ejection fraction(LVEF) were reduced with the increasing of NYHA gradings, the differences were statistically significant (P<0.05). Conclusion: The plasma β2-microglobulin level increases with the increasing of heart failure severity. Renal injury should be avoided which is induced by medicament in the treatment of patients with chronic heart failure ......
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