血清CA125水平与急性心肌梗死关系初探

Study on the relationship between the level of serum CA125 and acute myocardial infarction

目的观察急性心肌梗死患者血清糖类抗原125(CA125)水平的变化及其临床意义。方法心肌梗死组80例,在入院后第3天检查彩色多普勒超声心动图,测左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、舒张早期和晚期最大血流速度比(E/A)、平均肺动脉压(mPAP),根据LVEF分A组(LVEF>0.50,36例)和B组(LVEF≤0.50,44例),抽血检测心肌型肌酸磷酸激酶同功酶(CKMB)、肌钙蛋白T(TnT)的峰值浓度,并在入院后72h测血清CA125水平。对照组50例,既往无器质性心脏病史和异常心脏彩超改变。排除引起CKMB、TnT、CA125升高的其他因素。结果心肌梗死组和对照组LVEF、E/A、mPAP、CA125、CKMB、TnT差异有统计学意义(P<0.05);A组和B组LVEF、E/A、mPAP、CA125差异有统计学意义(P<0.05);CA125与LVEF、E/A呈负相关(r=-0.784,P<0.05和r=-0.621,P<0.05)。结论急性心肌梗死患者血清CA125水平升高,并与左室收缩和舒张功能密切相关。

Objective To observe the level of serum carbohytrate antigen 125 （CA125） in patients with acute myocardial infarction,and to explore the underlying mechanism for production and secretion of CA125. Methods The patient group, which included 80 eases with acute myocardial infarction, underwent eehocardiao- graphic examination on the third day of hospitalization. On the basis of echocardiographic findings, these 80 patients were grouped according to left ventricular ejection fraction （LVEF） values： LVEF〉0.5（group A ,n=36） and LVEF ≤0.50（ group B, n=44）. Other parameters, including left ventricular end-diastolic diameter （ LVEDD ）, ratio of peak early and late diastolic flow velocity（E/A）, and mean pulmonary artery pressure （mPAP）, were also measured on echocardiography. Serum concentration of CA125 was measured at the 72nd hour of hospitalization and peak serum concentrations of myocardial enzymes （MB isoenzyme of Creatine phosphokinase [CKMB ], troponin T [TnT] were also measured. Comparatively, the control group included 50 subjects with no history or evidence of overt cardiac disease and with normal eehocardiographie findings. The presence of any condition characterized by potential elevations in CA125 and myocardial enzymes （CKMB, TnT） was considered an exclusion criterion. Results A statistically significant difference was identified between the patient and control groups with regard to values for LVEF, E/A, mPAP, CA125, CKMB, TnT （P〈0.05 for all values）. Patients included in groups A and B differed significantly in terms of LVEF, E/A, mPAP, CA125 values （P〈0.05 for all values）. CA125 was found to be negatively correlated with LVEF（r=-0.784,P〈0.05） and E/A（r=-0.621,P〈0.05）. Conclusion The serum concentration of CA125 was elevated in patients with acute myocardial infarction, which was significantly correlated with left ventricular systolic and diastolic dysfunction.