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尿微量白蛋白/尿肌酐比值在慢性心力衰竭患者中的变化分析

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摘要:

目的 探讨尿微量白蛋白/尿肌酐比值(UACR)在慢性心力衰竭(CHF)患者中的变化
及分析。方法 选取2020年1月至2021年6月于我院收治的慢性心力衰竭患者140例作为研究对象(观察
组),另选取同期健康体检者70例作为对照组。按照美国纽约心脏病协会(NYHA)分级标准将观察
组分为四个亚组:NYHAⅠ级组(12例),NYHAⅡ级组(39例),NYHAⅢ级组(43例)和NYHAⅣ
级组(46例)。比较各组间患者的血肌酐(SCr)、尿微量白蛋白(UMA)、尿微量白蛋白/尿肌酐比
值(UACR)、N末端脑钠肽前体(NT-proBNP)、左心室射血分数(LVEF)、左心室舒张末期内径
(LEVDd)、左心室短轴收缩率(LVFS)水平,并对不同心功能分级患者的UACR进行分析比较。结果
观察组与对照组在UMA、UACR、SCr、NT-proBNP比较,观察组明显高于对照组,且观察组NYHA分级
越高,增加程度越明显;观察组LVEF、LVFS明显低于对照组,且NYHA分级越高降低越明显。观察组
LEVDd明显高于对照组,且NYHA分级越高增加越明显。差异有统计学意义(P<0.05)。不同NYHA分
级UACR水平比较,差异均有统计学意义(P<0.05)。结论 尿微量白蛋白、尿微量白蛋白/尿肌酐比值
测定操作简便,价格低廉,对于慢性心力衰竭患者病情严重程度的评估,具有一定参考价值,值得临床
推广。

Abstract:

Objective To investigate the changes of urea albumin creatinine ratio (UACR) in patients with chronic heart failure (CHF). Methods CHF patients were chosen into observation group (n=140) and healthy controls were chosen into control group (n=70) from Department of Cardiology in Chinese PLA General Hospital from Jan. 2020 to June 2021. According to New York Heart Association classification of heart function (NYHA), the observation group was divided into NYHA grade I subgroup (n=12), NYHA grade II subgroup (n=39), NYHA grade III subgroup (n=43) and NYHA grade IV subgroup (n=46). The levels of serum creatinine (SCr), urinary micro albuminuria (UMA), UACR, N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic inner diameter (LVEDd) and left ventricular fraction shortening (LVFS) were compared among all groups, and UACR was analyzed and compared among all subgroups. Results The levels of UMA, UACR, SCr and NT-proBNP were significantly higher in observation group than those in control group, and in observation group, the higher the NYHA grade, the more significant the increases of UMA, UACR, SCr and NT-proBNP. The levels of LVEF and LVFS were significantly lower in observation group than those in control group, and in observation group, the higher the NYHA grade, the more significant the decreases of LVEF and LVFS. The level of LEVDd was significantly higher in observation group than that in control group, and in observation group, the higher the NYHA grade, the more significant the increases of LEVDd (P<0.05). The comparison in UACR level among all subgroups showed that the difference had statistical significance (P<0.05). Conclusion The detections of UMA and UACR are easy and cheap, which has some reference value to assessing disease severity in CHF patients, and is worth clinical promoting.

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