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Objective:To investigate the relationship between plasma N-terminal B-type natriuretic peptide precursor (NT-proBNP), hypersensitive C-reactive protein (hs-CRP), troponin Ⅰ (cTnⅠ) and carbohydrate antigen 125 (CA125) and cardiac function in patients with acute heart failure.Methods:From May 2017 to May 2019, 97 patients with acute heart failure admitted to Hangzhou Dajiangdong Hospital were selected as the observation group.According to the cardiac function classification of New York Heart Association (NYHA), 29 patients were classified as grade Ⅱ group, 51 patients as grade Ⅲ group and 17 patients as grade Ⅳ group.Fifty healthy people were selected as control group.The changes of plasma NT-proBNP, hs-CRP, cTnⅠ and CA125 levels, left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were compared between the two groups.The changes of plasma NT-proBNP, hs-CRP, cTnⅠ and CA125 levels, as well as the changes of LVED and LVEF in the different heart function grading group were compared.The correlation between plasma NT-proBNP, hs-CRP, cTnⅠ, CA125 and LVEDD, LVEF was analyzed.Results:The plasma NT-proBNP[(5 684.21±174.39)ng/L], hs-CRP[(16.54±3.27)mg/L], cTnⅠ[(0.43±0.13)g/L] and CA125[(83.24±15.46)U/mL] in the observation group were higher than those in the control group( t=216.813, 25.684, 19.432, 34.138, all P<0.05). The LVEDD in the observation group[(63.21±4.87)mm] was higher than that in the control group[(48.97±2.41)mm], and the LVEFin the observation group[(39.27±3.25)%] was lower than that in the control group[(62.87±4.36)%], the differences were statistically significant ( t=19.461, 37.008, all P<0.05). The levels of NT-proBNP[(7 368.18±201.05)ng/L], hs-CRP[(24.19±4.18)mg/L], cTnⅠ[(0.63±0.14)μg/L] and CA125[(164.52±27.48)U/mL] in the grade Ⅳ group were higher than those in the grade Ⅱ group and grade Ⅲ group(grade Ⅲ group: t=31.109, 6.557, 5.321, 13.017; grade Ⅱ group: t=75.873, 16.582, 11.755, 23.178, all P<0.05). The plasma NT-proBNP[(5 751.42±180.34)ng/L], hs-CRP[(15.98±4.56)mg/L], cTnⅠ[(0.41±0.15)g/L] and CA125[(87.97±18.45)U/mL] in the grade Ⅲ group were higher than those in the grade Ⅱ group[(3 481.34±145.26)ng/L, (8.23±2.37)mg/L, (0.25±0.08)μg/L and (28.43±12.21)U/mL]( t=57.893, 8.507, 5.320, 15.530, all P<0.05). The LVEDD[(67.95±5.15)mm] in the grade Ⅳ group was higher than that in the grade Ⅱ group and grade Ⅲ group(grade Ⅲ group: t=3.553, grade Ⅱ group: t=8.157, P<0.05), while the LVEF[(34.28±2.36)%] in the grade Ⅳ group was lower than that in the grade Ⅱ group and grade Ⅲ group(grade Ⅲ group: t=6.673, grade Ⅱ group: t=10.417, all P<0.05). The LVEDD[(62.78±5.21)mm] in the grade Ⅲ group was higher than that in the grade Ⅱ group[(57.87±3.25)mm]( t=4.586, P<0.05), while the LVEF in the grade Ⅲ group[(39.98±3.24)%] was lower than that in the grade Ⅱ group[(45.98±4.25)%]( t=7.097, P<0.05). LVEDD was positively correlated with NT-proBNP, hs-CRP, cTnⅠ and CA125, while LVEF was negatively correlated with NT-proBNP, hs-CRP, cTnⅠ and CA125. Conclusion:The levels of NT-proBNP, hs-CRP, cTnⅠ and CA125 in plasma of patients with acute heart failure are elevated, and they are significantly correlated with cardiac function grading and cardiac function indicators.
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Objective To explore the short－term and long－term clinical efficacy of aspirin combined with ticagrelor in the treatment of acute coronary syndrome ( ACS) patients with non －revascularization, to assess the improvement of cardiac function.Methods A total of 114 ACS patients with non －revascularization in Dajiang Hospital of Hangzhou were selected .They were randomly divided into control group and study group by random number table method,with 57 patients in each group.The control group was given aspirin and clopidogrel conventional therapy.The study group was treated with aspirin and ticagrelor .The clinical efficacy was evaluated .The Grace scores of ACS before and after treatment were evaluated ,and the serum levels of lactate dehydrogenase (LDH) and creatine phosphokinase(CPK) were measured.The patients were followed up for 12 months,the incidence of primary and secondary end points and the occurrence of dyspnea were observed .Results The total effective rate of the study group was 87.72%(50/57),which was higher than 71.93%(41/57) of the control group,the difference was statis－tically significant(χ2＝10.65,P＜0.05).The incidence rates of primary end point and secondary end point of the study group were 12.28%(7/57) and 17.54%(10/57),respectively,which were lower than 21.05%(12/57) and 35.09%(20/57) of the control group,the differences were statistically significant(χ2＝9.82,10.13,all P＜0.05). The incidence rate of dyspnea of the study group was 24.56%(14/157),which was higher than 3.51%(2/57) of the control group,the difference was statistically significant (χ2＝10.96,P＜0.05).The Grace score of the study group was (80.23 ±7.89)points,which was lower than (85.58 ±8.14) points of the control group,the difference was statistically significant(t＝9.38,P＜0.05).The levels of LDH and CPK of the study group were (217.06 ±44.34)U/L and (167.52 ±37.41)U/L,respectively,which were lower than (261.58 ±43.10)U/L and (225.48 ±38.26)U/L of the control group,the differences were statistically significant (t＝10.06,10.29,all P＜0.05).Conclusion Aspi－rin combined with ticagrelor for ACS patients with non －revascularization can effectively inhibit platelet aggregation , the clinical efficacy is significant ,the incidence of primary and secondary end points of patients with ACS was signifi －cantly reduced,the prognosis is good .While dyspnea rate increased ,but does not affect the treatment of patients .
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0.05),and there was significant difference in ICA,VP,RI,AT,and the levels of TXB_2 and 6-K-PGF_(1?) of the blood plasma(P