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目的在老年射血分数保留心衰(heart failure with preserved ejection fraction,HFPEF)患者人群中,探索血清胱抑素C(Cystatin C)水平与左室肥厚的关系。方法对符合入选条件的234例老年HFPEF患者及209例对照进行血清Cystatin C水平检测;并完善超声心动图检查,测定舒张期末室间隔厚度(IVST)、左室内径(LVID)、左室后壁厚度(LVPW),计算左室重量及左室重量指数(LVMI)。结果 HFPEF组与对照组比较,LVMI及Cystatin C差异有统计学意义(P<0.001)。Pearson相关分析发现,HFPEF患者中LVMI与Cystatin C呈显著正相关(r=0.258,P<0.001);应用多元线性回归分析建立左室肥厚风险的混合模型,校正了年龄、血压、血糖、血脂等因素后,Cystatin C与左室肥厚(LVMI)独立相关(β值=11.38,P<0.001)。结论在老年HFPEF人群中,血浆Cystatin C水平与左室肥厚相关,提示早期肾功能损害与老年HFPEF有关。
Objective To explore the relationship between serum cystatin C and left ventricular hypertrophy in the population of patients with heart failure and preserved ejection fraction (HFPEF). Methods Serum levels of Cystatin C were measured in 234 elderly HFPEF patients and 209 controls eligible for enrollment. Echocardiography was performed to measure IVST, LVID, left ventricular posterior wall Thickness (LVPW), left ventricular mass and left ventricular mass index (LVMI) were calculated. Results Compared with the control group, the differences of LVMI and Cystatin C in HFPEF group were statistically significant (P <0.001). Pearson correlation analysis showed that there was a significant positive correlation between LVMI and Cystatin C in HFPEF patients (r = 0.258, P <0.001) .Multivariate linear regression analysis was used to establish a mixed model of risk of left ventricular hypertrophy and adjusted for age, blood pressure, blood glucose, blood lipids After the factor, Cystatin C was independently associated with LVMI (β = 11.38, P <0.001). Conclusions In elderly HFPEF population, the plasma Cystatin C levels correlate with left ventricular hypertrophy, suggesting that early renal impairment is associated with HFPEF in the elderly.