心力衰竭患者血清CA125、CA19-9水平变化及意义

The Change of Serum levels of Carbohydrate Antigen 125 and 19-9 in Patients with Heart Failure and Its Significance

目的探讨慢性心衰(CHF)患者血清CA125、CA19-9水平变化及意义。方法(1)研究对象与分组:心衰组(CHF),按AHA指南标准随机人选17例慢性心衰患者,心功能Ⅱ-Ⅳ级(NY-HA),年龄36-86(51.7±13.2)岁。其中风湿性心脏病4例,高血压6例,冠心病5例,贫血性心脏病1例,其他1例;在这17例病例中合并心包积液2例、胸腔积液1例、心房纤颤3例,左心房及静脉血栓1例;非心衰组(NHF),冠心病(非心衰者)、高血压Ⅰ期患者13例,年龄21-77岁,健康对照组(Control),健康成年人15例,年龄25-73岁;(2)CA125、CA19-9测定:抽取清晨空腹静脉血5ml,化学发光免疫法测定血清CA125、CA19-9水平。同时,检测肿瘤三项(CEA、AFP、SF)、胸片、头颅CT以及腹部、盆腔超声,排外潜在的肿瘤;(3)统计学分析:数据采用均数±标准差(x±s)表示,t检验,P<0.05有统计学意义。结果与非心衰组和健康对照组比较,心衰组血清CA125显著升高,且与心衰严重程度(Ⅱ、Ⅲ、Ⅳ级)相关(分别P<0.01,P<0.001,P<0.001);非心衰组与健康对照组比较,无显著差别(P>0.05)。然而,各组间CA19-9水平无显著变化(P>0.05)。同时,发现合并心包、胸腔积液,尤其慢性房颤者,CA125显著升高。结论CA125是诊断和评价慢性心衰的一个良好指标,且与心衰程度相关,而CA19-9与心衰无明显关系。

Objective To study the change of serum levels of carbohydrate antigen （CA） 125 and CA19-9 in patients with chronic heart failure （CHF） and its significance. Methods （ 1 ） Subjects and Groups： CHF group： to collect at random 17 patients with CHF according to AHA guideline, NYHA Ⅲ-Ⅳ of cardiac function, aged from 36 to 86 （51.7 ± 13.2） years, 8 males, 9 females, with diagnosis of rheumatic heart diseases（RHD） in 4, hypertension in 6, coronary heart diseases （CHD） in 5, anemic heart diseases in 1, others in 1 ; Companied with pericardial effusion in 2, pleural effusion in 1, atrial fibrillation in 3, left atrial and intravenous thrombus in 1. Non-heart failure （NHF） group： 13 patients with CHD （NHF） and phase 1 hypertension, aged from 21 to 77 years, 5 males, 8 females. Healthy control group： 15 healthy adults, aged from 25 to 73 years, 8 males, 7 females; （2） Assay of CA125 and CA19-9 levels： to take 5ml venous blood of subjects at early morning and measure serum levels of CA125 and CA19-9 by chemoluminescence immuno-analysis. At the same time, to measure 3 items of tumors including CEA, AFP and SF ; Chest X-ray, CT and Ultrasound B for rejecting probable tumors; （3） Statistical analysis： data were showed with mean ＋ standard deviation, t tests and a p-value 〈 0.05 was considered statistically significant. Results To compare with NHF group and healthy control group, there was greatly elevated in CA125 levels in CHF group and, was related to the severity ofCHF （NYHA Ⅱ,Ⅲ,Ⅳ, P〈 0.01, P〈0.001, P〈0.001, respectively） ; To compare with healthy control group, no significant in NHF group （P 〉0.05）. However, no significant among groups in CA19-9 levels （ P 〉 0.05 ）. At the same time, we found that there were greatly elevated in CA125 levels in patients with CHF, which companied with pericardial and pleural effusion, espe- cially chronic atrial fibrillation. Conclusions CA125 is a good index for CHF diagnosis and assessment, which is related to the severity of CHF, however, there is no significant relationship between CA19-9 levels and CHF.