| Objective: By observing the serum level of cystatin C in heart failure patients to investigate the relationship between cystatin C and cardiac function in patients with heart failure with type 1 cardiorenal syndrome and its clinical significance..Method: A total of 211 HF patients,were admitted to the department of cardiovascular medicine(east hospital)of the second affiliated hospital of University of South China from October 2016 to May 2018.Collect the patient's general information,inspection result(routine blood?Cystatin C?liver function?renal function?electrolyte?NT-pro BNP),relevant data of Color Sonography(LVESD?LVEDD?E/A?LVEF).Grouping by level of Cystatin C,the group with Cystatin C ?1.4mg/ml was the group with elevated Cystatin C,and the group with Cystatin C<1.4 mg/ml was the group with normal Cystatin C.Grouping by level of serum creatinine: CRS group met the diagnostic criteria for AKI,and control group did not meet the diagnostic criteria for AKI.Grouping by NYHA cardiac function grade: The CRS group was divided into NYHA cardiac function grade II,NYHA cardiac function grade III and NYHA cardiac function grade IV.Grouping by level of LVEF: LVEF<40% is heart failure with reduced ejection fraction(HFrEF),LVEF40%-49% is heart failure with intermediate ejection fraction(HFmrEF),and LVEF 50% is heart failure with preserved ejection fraction(HFpEF).Correlation analysis of clinical data was conducted among each group.Finally,clinical data between groups were statistically analyzed using SPSS 21.0 statistical software.Result:1.Comparison between the normal group and the elevated group of Cystatin C: the difference in age between the two groups was statistically significant(P<0.05),gender?history of hypertension?history of diabetes mellitus?course of disease and history of smoking were not statistically significant(P>0.05).Compared with the normal group,Cystatin C?LVEDD?NT-pro BNP?serum creatinine?urea nitrogen were increased in the Cystatin C elevated group,LVEF decreased,NYHA cardiac function grade risen,the difference was statistically significant(P<0.05).2.Comparison between the control group and the CRS group: there were statistically significant differences between the two groups in gender(P<0.05),age?history of hypertension?history of diabetes mellitus?course of disease and history of smoking were not statistically significant(P>0.05).Compared with the control group,LVEDD?NT-pro BNP?urea nitrogen?Cystatin C in the CRS group were all increased,LVEF were decreased,NYHA cardiac function grade risen,the differences were statistically significant(P<0.05).3.Comparison between groups with different NYHA cardiac function grades in CRS group: Compared with NYHA cardiac function grade II group,Cystatin C?NT-pro BNP?LVEDD?serum creatinine?urea nitrogen in NYHA cardiac function grade IV group were increased,LVEF were decreased,the differences were statistically significant(P<0.05).Compared with NYHA cardiac function grade III group,Cystatin C?NT-pro BNP in NYHA cardiac function grade IV group were increased,LVEF were decreased,the difference was statistically significant(P<0.05).Compared with NYHA cardiac function grade II group,Cystatin C was significantly increased in NYHA cardiac function grade III group,with statistically significant differences(P<0.05).4.Comparison of different types of heart failure in the CRS group: Compared with the HFpEF group,Cystatin C?NT-pro BNP?LVEDD?serum creatinine and urea nitrogen in the HFrEF group were increased,LVEF were decreased,and NYHA cardiac function grade was risen,with statistically significant differences(P<0.05).Compared with the HFmrEF group,NT-pro BNP and LVEDD in the HFrEF group were significantly increased,LVEF were significantly decreased,the difference was statistically significant(P<0.05).Compared with HFpEF group,LVEDD was significantly increased and LVEF was significantly decreased in HFmrEF group,and the difference was statistically significant(P<0.05).5.Spearman analysis showed that there was a significant positive correlation between Cystatin C and NYHA cardiac function grades?NT-pro BNP ? LVEDD ? serum creatinine ? urea nitrogen,and a significant negative correlation between Cystatin C and LVEF(P<0.05).6.Logistic binary regression analysis showed that: gender,Cystatin C and urea nitrogen were risk factors for type 1 CRS,gender was the protective factor,OR value was 0.277.Cystatin C and urea nitrogen were risk factors,OR values were 8.248 and 1.231.Conclusion:1.Cystatin C has a significant positive correlation with NYHA cardiac function grading,NT-pro BNP,and a significant negative correlation with LVEF.2.Serum cystatin C was significantly increased in patients with heart failure complicated with type 1 cardiorenal syndrome,which was one of the risk factors for type 1 cardiorenal syndrome,suggesting that serum cystatin C may be associated with the risk of type 1 cardiorenal syndrome;Cystatin C can be used to assess the severity of heart failure with type 1 cardiorenal syndrome. |
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