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1、血清胱抑素C在慢性心力衰竭早期診斷中的臨床意義 【摘要】目的分析血清胱抑素?β?性心力衰竭早期診斷的意義。方法106例住院患者，將患者分為對(duì)照組和病例組。對(duì)照組為既無器質(zhì)性心臟病又無心力衰竭癥狀的患者，病例組包括既有器質(zhì)性心臟病和心力衰竭癥狀的患者。對(duì)兩組進(jìn)行基線分析，采用Logistic單因素和多因素分析，確定CHF的獨(dú)立危險(xiǎn)因素。進(jìn)行受試者工作特征曲線分析確定CysC作為CHF早期的評(píng)價(jià)指標(biāo)的最佳界值。結(jié)果病例組患者的CysC水平mg/L，明顯高于對(duì)照組患者的mg/L，差異有統(tǒng)計(jì)學(xué)意義。相關(guān)性分析發(fā)現(xiàn)，在單
2、因素分析中CysC在CHF早期診斷的OR值為17.701，說明CysC與CHF早期密切相關(guān)。調(diào)整相關(guān)影響因素后進(jìn)行多因素Logistic回歸分析，發(fā)現(xiàn)CysC無論是作為連續(xù)變量還是二分類變量，其都是CHF早期的重要危險(xiǎn)因素，提示CysC可能是CHF早期的獨(dú)立危險(xiǎn)因素。通過ROC曲線獲得CysC作為CHF早期診斷評(píng)價(jià)指標(biāo)的最佳界點(diǎn)值是0.8850mg/L，靈敏度為77.5%，特異度為71.4%，結(jié)果說明此界值有較好的靈敏度和特異度。結(jié)論CysC是CHF的獨(dú)立危險(xiǎn)因素，對(duì)CHF早期診斷具有重要臨床意義?！ 娟P(guān)鍵詞】
3、慢性心力衰竭；血清胱抑素C；臨床診斷 DOI：10.14163/j.cnki.11-5547/r.2017.17.003 ClinicalsignificanceofserumcystatinCinearlydiagnosisofchronicheartfailureTENGYan-chun，PANHong.ShenzhenCityBaoanDistrictFuyongPeople’sHospital，Shenzhen518100，China 【Abstract】ObjectiveToanalyzesign
4、ificanceofserumcystatinCinearlydiagnosisofchronicheartfailure.MethodsAtotalof106hospitalizedpatientswererandomlydividedintocontrolgroupandcasegroup.Thecontrolgroupcontainedpatientswithoutorganicheartdiseaseandheartfailuresymptoms，andthecasegroupcontainedpatie
5、ntswithorganicheartdiseaseandheartfailuresymptoms.Bothgroupsreceivedbaselineanalysis.UnivariateandmultivariateLogisticanalysiswereappliedtodetermineindependentriskfactorforCHF.Receiveroperatingcharacteristiccurvewasusedtoanalyzeanddeterminethebestcut-offvalue
6、byCysCasearlyevaluationindexforCHF.ResultsThecasegrouphadobviouslyhigherCysClevelasmg/Lthanmg/Linthecontrolgroup，andtheirdifferencehadstatisticalsignificance.CorrelationanalysisshowedORvaluebyCysCas17.701inunivariateanalysisforearlydiagnosisofCHF，anditshowedc
7、losecorrelationbetweenCysCandearlyCHF.MultivariateLogisticanalysisafterregulationofrelatedinfluencingfactorsshowedCysC，actingascontinuousvariableorbinaryvariable，astheimportantriskfactorforearlyCHF.CysCwassuggestedastheindependentriskfactorforearlyCHF.ROCcurv
8、eshowedthatbestcut-offvalueas0.8850mg/LbyCysCasearlyevaluationindexforCHF，alongwithsensitivityas77.5%andspecificityas71.4%.Thecut-offvaluecontainedgoodsensitivityandspecificity.Conclusion
