Changes And Clinical Significances Of Cystatin C And Urinary Microalbumin/Creatinin Ratio (UACR) In Chronic Congestive Heart Failure

Objective Caused by observing the different causes of chronic congestive heart failure (Congestive heart failure) in patients with serum Cystatin C(Cystatin C) and urinary microalbumin/creatinine ratio in urine (Urinary Microalbumin/increatinin ration,UACR), discussion on serum Cystatin C and urinary microalbumin/creatinine ratio in urine and the relationship between the different causes of chronic heart failure; Simultaneous detection of different levels of cardiac function in patients with heart failure of serum Cystatin C and urinary microalbumin/creatinine ratio in urine, evaluating its significance in the diagnosis and treatment of heart failure.Methods Selects from January,2011toFebruary,2012year period because the chronic heart fades the hospital treatment patient124examples in the Shanxi medical college second affiliated hospital heart internal medicine department, in which male69examples, the feminine55examples, the age46-92(64.85±12.85) year old, average course of disease is4.49±1.64year.Elects the patients according to the heart function-graduation standard (American New York Heart disease Academic society, NYHA, heart function graduation) to divide into3groups: Heart function Ⅱ Level group34examples; Heart functionⅢLevel group34examples; Heart function Ⅳ level of group56examples.The cause of disease includes:heart disease in33cases of hypertension, ischemic cardiomyopathy in28cases,26cases of dilated cardiomyopathy,37cases of rheumatic valvular heart disease. Selected case of illness good cardiac ultrasound, inspections and so on sternum, liver function, kidney merit, blood sugar, and with the rubber latex turbidimetric method examination blood serum bladder chalone C level, the enzyme exempts the law determination urine micro albumin level, Jaffe responds the examination urine myo-bitter wine level. Under condition needs of patients taking diuretics, angiotensin receptor antagonist and (or) angiotensin converting enzyme inhibitors, β-receptor blocking agents and other medications, if necessary by taking Digitalis. Selection healthy control group37examples, masculine21examples, feminine16examples, age39-82year old.Results1. Different groups of cardiac function and normal compared, in fasting plasma glucose, low density lipoprotein, high-density lipoprotein cholesterol (hdl-c) without significant difference (P>0.05), and serumCys C level, microalbuminuria/urine creatinine ratio with heart failure increasing and increase, and cardiac function level Ⅳ group> Ⅱ level group> Ⅲlevel group> normal control group, which will have a statistically significant (P<0.05, P<0.01); Blood sodium levels with heart failure and reduce intensified, and cardiac function level IV group <II level group<IIIlevel group<normal control group, in addition to level with the group II cardiac function of normal control group there were no significant differences between the (P>0.05), and the rest are between each group is a statistically significant (P<0.05, P<0.01); Urea nitrogen, serum creatinine, uric acid level IV in cardiac function only increased significantly between groups, total cholesterol, triglyceride level IV groups only in cardiac function between reduced significantly, and are in the normal control group and level IV groups, and cardiac function Ⅱ level and the level IV between group with significant difference (P<0.01), the more no significant differences between groups (P>0.05); Hemoglobin in the normal control group and cardiac function III level group level IV and between groups, and cardiac function II level and the level IV between group with significant difference (P<0.01), the more no significant differences between groups (P>0.05).2. Different causes:a group of Group of hypertensive heart disease, ischemic heart disease, dilated cardiomyopathy group, between groups of patients with rheumatic heart disease, serum Cystatin c and urinary microalbumin/creatinine levels in urine, compared to no significant differences between the four groups (P>0.05).3. Serum CysC level and urinary microalbumin/creatinine ratio in urine concentration relation with infection:serum CysC level and urinary microalbumin/creatinine levels in urine associated with infection-free (P>0.05).4.Using correlation analysis showed that serum Cystatin C and urinary microalbumin/crea-tinine ratio in urine, blood urea nitrogen, serum creatinine,uric acid level and cardiac function arerelated (r=0.412, P<0.01; r=0.426, P<0.01; r=0.495, P<0.01; r=0.269, P<0.01; r=0.244, P<0.01); Linear correlation analysis showed hemoglobin and serum sodium level (r=-0.260, P<0.01; r=-0.496, P<0.01)Conclusions1. Heart failure patients in serum inhibition change C level, microalbuminuria/urine creatinine ratio in the different causes no obvious difference, but with the rise of levels of cardiac function increase, show that the severity and heart failure is closely related to both can reflect the heart failure as a hint of the severity of illness monitoring index;2. In serum inhibition change C. microalbuminuria/urine creatinine ratio in cardiac function II, III that have a significantly higher level group, urea nitrogen, serum creatinine level IV group in only just increased significantly.tip in serum inhibition change C, microalbuminuria/urine creatinine ratio is to evaluate the degree of severe heart failure patients sensitive index;3. In serum inhibition change C. microalbuminuria/urine creatinine ratio from infection factors, urea nitrogen, serum creatinine and has close relationship with infection.