The Clinic Study Of Subclinic Renal Hypofunction In Chronic Heart Failure Patientes

Objective:To observe the level of cystatin C (CysC) in serum, microalbuminurla (MA) in urine,β2-microglobulin (P2-MG) in blood andβ2-microglobulin, N-acetyl-β-D- gincosa (NAG), retinol binding protein (RBP) in urine of the chronic heart failure patients with normal creatinine, to investigate the relationship between subclinic renal function with heart function, and to find a valuable biological marker of subclinic renal hypofunction.Methods:Line the group of 70 chronic heart failure patients with normal creatinine (constitutional kidney disease, constitutional liver disease, endocrine disease, hematonosis, malignant tumor and glucocorticoid users have been ruled out) and 30 healthy volunteers formed the control group. The CHF group was divivided into 3 groups according to New York Heart Association (NYHA). We collected the data of every group's gender, age, and recorded the clinic indexes of blood routine. Left ventricular fraction (LVEF), and renal function, such as CysC in serum, MA in urine, P2-MG in blood andβ2-MG, NAG, RBP in urine were examined and analyzed in every group.Results:1. The CHF group's blood routine indexes such as RBC, Hb, Hct were significantly lower than the control group; the CHF group's SCr, CysC in seurm, P2-MG in blood, MA in urine compared to the control group, the diffience have satatical significant.2. The levels of CysC in seurm,β2-MG in blood and MA in urine of patients with NYHAⅡ-Ⅳgrade were significantly higher than those of control group; and CysC in seurm increased with the increase of New York Heart Assoiation function grade.3. LVEF in CHF group was significatly negative correlated with CysC in serum (r= -0.462, P=0.001), negative correlated withβ2-MG in blood (r=-0.342, P=0.04), and negative correlated with MA in urine.4.When LVEF was taken as dependent variable, the age, SCr, CysC in serum, MA in urine, glomerular filtration rate (GFR),02-MG in blood,β2-MG in urine, NAG in urine and RBP in urine as independent variables, CysC in serum, GFR and MA in urine enter the regression equation, and they were correlated with LVEF independently.Conclusions:1. The levels of CysC in serum, MA in urine andβ2-MG in blood increased significantly, showing that there was early renal hypofunction character of glomerular filtration functional lesion in chronic heart failure patients. The more severe the heart failure, the more significant the renal function impairment.2. The levels ofβ2-MG, NAG, RBP in urine were in ranges of nromal valve, showing that there was normal tubular reabsorption function in chronic heart failure patients.3. CysC in serum had diagnostic value for early renal hypofunction in chronic heart failure patients.