目的 分析与探讨血清25-(OH)D₃、hsCRP及NT-proBNP在不同程度心力衰竭患者中的表达,并研究其与疾病预后的相关性及指导价值。方法 选择2015-2017年检查确诊的108例慢性心力衰竭患者作为慢性心力衰竭组,随机选取108例体检健康者作为健康对照组。比较两组血清25-(OH)D₃、hsCRP、NT-proBNP检测值,观察不同心力衰竭程度及发生主要心血管不良事件(MACE,the major adverse cardiovascular events,包括心血管死亡、非致死性心肌梗死及卒中)时三种血清因子检测值变化。结果 慢性心力衰竭组与对照组比较,血清25-(OH)D₃检测值明显下降,hsCRP、NT-proBNP检测值明显上升,差别存在统计学意义(P<0.05)。慢性心力衰竭组医治后25-(OH)D₃(20.85±4.87)μg/L、hsCRP(10.58±3.04)mg/L及NT-proBNP(926.17±267.11)pg/ml检测值均优于医治前25-(OH)D₃(14.56±4.33)μg/L、hsCRP(17.69±3.68)mg/L及NT-proBNP(1588.64±574.39)pg/ml检测值,差异有统计学意义(P<0.05)。随着心力衰竭严重程度加重,血清25-(OH)D₃检测值明显降低、血清hsCRP、NT-proBNP检测值明显增高,差异有统计学意义(P<0.05)。有MACE患者血清25-(OH)D₃(10.62±3.44)μg/L低于未发生组25-(OH)D₃(14.29±3.21)μg/L,同时血清中hsCRP(18.99±3.25)mg/L、NT-proBNP(1688.34±375.66)pg/ml高于未发生组hsCRP(15.76±1.34)mg/L、NT-proBNP(1320.48±262.77)pg/ml,差异有统计学意义(P<0.05)。结论 慢性心力衰竭疾病发展过程中,血清25-(OH)D₃、hsCRP、NT-proBNP的表达水平高低,对心力衰竭严重程度的判断存在指导意义,且随着病情的控制,三项指标检测值均明显改善,提示与慢性心力衰竭的治疗转归及预后存在明显相关性。

Objective To analyze and explore the expressions of serum 25(OH)D₃, hsCRP and NT-proBNP in patients with different degrees of heart failure, and to study their correlations with and guidance for the prognosis of the disease.Methods One hundred and eight patients with chronic heart failure who had been diagnosed at our hospital between 2015 and 2017 were selected as the study group, while another 108 healthy subjects were randomly selected as the control group. Serum 25(OH)D₃, hsCRP and NT-proBNP values were compared between the two groups.The degree of heart failure and changes in three serum factor values in case of major adverse cardiovascular events (MACE, including cardiovascular death, nonfatal myocardial infarction and stroke) were observed.Results Compared with control group, the serum 25(OH)D₃ detection value decreased significantly, while the detection value of hsCRP and NT-proBNP increased significantly, and the difference was statistically significant (P<0.05). In the study group, 25(OH)D₃ was (20.85±4.87) ug/L, hsCRP (10.58±3.04)mg/L and NT-proBNP (926.17±267.11) pg/ml after treatment, compared to (14.56±4.33) μg/L, (17.69±3.68 )mg/L and (1588.64±574.39) pg/ml, so the difference was statistically significant (P<0.05). As the severity of heart failure increased, the detection value of serum 25(OH)D₃ decreased significantly, while those of serum hsCRP and NT-proBNPwere significantly increased, with statistical significance (P<0.05). Serum 25(OH)D₃ of patients with MACE was(10.62±3.44) μg/L, lower than (14.29±3.21) μg/L among those without MACE, but serum hsCRP of the former was(18.99±3.25 mg/L0, and NT-proBNP was(1688.34±375.66) pg/ml, compared to(15.76 ± 1.34) mg/L and (1320.48±262.77) pg/ml of the latter, and the difference was of statistical significance (P<0.05).Conclusions During the progression of chronic heart failure, the expression levels of serum 25(OH)D₃, hsCRP and NT-proBNP can help the diagnosis of the severity of heart failure. The three indicators can improve with more effective control of the disease.