糖类抗原125与N末端B型利钠肽原相结合在慢性心力衰竭中的应用
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Application of Carbohydrate Antigen 125 and Amino-terminal Pro-brain Natriuretic Peptide in Patients with Chronic Heart Failure
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    摘要:

    目的 探讨糖类抗原125(CA125)与N末端B型利钠肽原(NT-proBNP)相结合对慢性心力衰竭患者病情评估和治疗的指导作用。方法 选择284例心脏病患者,测定血清CA125和NT-proBNP水平。根据纽约心脏学会(NYHA)心功能分级标准比较心功能Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级患者间两者水平有无差异;再根据患者肾功能是否正常,分别比较肾功能正常组和肾功能异常组不同心功能程度患者间两者水平的差异。结果 284例心脏病患者,CA125和NT-proBNP水平有显著相关性(r=0.49,P<0.01);NT-proBNP水平在心功能Ⅰ级、Ⅱ级、Ⅲ级患者中随心功能分级程度增高而升高,差异有统计学意义(P<0.05),但心功能Ⅳ级患者NT-proBNP水平低于心功能Ⅲ级患者,差异无统计学意义;CA125水平随心功能分级程度增高而升高,差异有统计学意义(P<0.05)。145例肾功能正常[eGFR≥60 mL/(min·1.73 m2)]患者CA125和NT-proBNP水平均随心功能分级程度增高而升高,差异有统计学意义(P<0.05),二者之间有显著相关性(r=0.700,P<0.01);139例肾功能异常[eGFR<60 mL/(min·1.73 m2)]患者CA125和NT-proBNP水平有显著相关性(r=0.292,P<0.01),NT-proBNP水平在心功能Ⅰ级、Ⅱ级、Ⅲ级随心功能分级增高而升高,差异有统计学意义(P<0.05),但心功能Ⅱ级与心功能Ⅳ级之间差异无统计学意义,且心功能Ⅳ级患者NT-proBNP水平显著低于心功能Ⅲ级患者(P<0.05),而CA125水平随心功能分级程度增高而升高,差异有统计学意义(P<0.05)。结论 血清CA125和NT-proBNP水平在慢性心力衰竭患者中均升高,二者均可作为评估慢性心力衰竭患者心功能的有价值指标;但肾功能异常会影响NT-proBNP水平,对CA125水平则无明显影响。因此,CA125与NT-proBNP相结合对指导慢性心力衰竭患者诊疗,尤其当肾功能不全时,具有重要价值。

    Abstract:

    Aim To explore the application of carbohydrate antigen 125 (CA125) and amino-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with chronic heart failure. Methods 284 patients with cardiac diseases were divided into four groups (Heart function Ⅰ,Ⅱ,Ⅲ,Ⅳ) according to New York Heart Association (NYHA) class and their serum concentrations of CA125 and NT-proBNP were tested respectively. Then,combined with renal function we respectively compared the level of CA125 and NT-proBNP in the patients with normal renal function or impaired renal function. Results CA125 and NT-proBNP had a significant correlation (r=0.49,P<0.01) in 284 chosen patients. NT-proBNP concentration was increasing with the level of heart function grade in patients with heart function (Ⅰ,Ⅱ,Ⅲ)(P<0.05),but NT-proBNP concentration was lower in the patients with heart function Ⅳ than the patients with heart function Ⅲ. However,CA125 concentration was significantly increasing with the level of heart function grade (P<0.05). In addition combined with renal function,CA125 and NT-proBNP concentration were both significantly increasing with the level of heart function grade (P<0.05) and had a significant correlation (r=0.700,P<0.01) in 145 patients with normal renal function (eGFR≥60 mL/(min·1.73 m2)). Among 139 patients with impaired renal function (eGFR<60 mL/(min·1.73 m2)),CA125 and NT-proBNP had a significant correlation (r=0.292,P<0.01),NT-proBNP concentration was increasing with the level of heart function grade in patients with heart function (Ⅰ,Ⅱ,Ⅲ) (P<0.05),but NT-proBNP concentration was significantly lower in the patients with heart function Ⅳ than the patients with heart function Ⅲ (P<0.05),however CA125 concentration was significantly increasing with the level of heart function grade (P<0.05). Conclusions Concentration of CA125 and NT-proBNP in serum showed a significant correlation with heart function and could be valuable index in the diagnosis of heart failure. Impaired renal function could interfere with the NT-proBNP concentration,but did not affect the CA125 concentration. Thus,NT-proBNP combined with CA125 would be very useful method to establish diagnosis and treatment in heart failure,especially with renal dysfunction.

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姜 锋,刘颖望,周 安,赵水平.糖类抗原125与N末端B型利钠肽原相结合在慢性心力衰竭中的应用[J].中国动脉硬化杂志,2015,23(09):932~936.

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  • 收稿日期:2014-12-25
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  • 在线发布日期: 2015-07-21