血浆结缔组织生长因子对心力衰竭的诊断价值

Connective tissue growth factor is an effective tool for diagnosis of heart failure

目的探讨血浆结缔组织生长因子(CTGF)浓度对临床上心力衰竭患者的诊断价值。方法评估100例心力衰竭患者(心衰组),根据NYHA分级,心衰组按心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ级分为第一组、第二组、第三组、第四组,对照组为25例健康体检者,测定研究对象的血浆CTGF水平,将血浆CTGF浓度和其他纤维化标志物与临床及超声心动图的数据进行评估和比较。结果心衰各组患者血浆CTGF浓度均明显高于对照组,对照组测定值为(0.7994±0.1650)ng/ml,第一组测定值为(1.1124±0.2512)ng/ml(P<0.01),第二组测定值为(1.2563±0.2983)ng/ml(P<0.01),第三组测定值为(1.2886±0.3864)ng/ml(P<0.01),第四组测定值为(1.3539±0.3241)ng/ml(P<0.01),心衰患者中,血浆CTGF浓度与血浆脑钠肽的浓度显著正相关(r=0.396,P<0.01),与血浆转化生长因子β正相关(r=0.518,P<0.01),与组织多普勒评估的E/A值呈负相关(r=-0.446,P<0.05),但不与反映左心室收缩功能的EF值相关。结论血浆CTGF浓度可作为一种新的心衰诊断标志物应用于临床。

Objective To investigate the clinical utility of plasma connective tissue growth factor(CTGF)concentration for the diagnosis of heart failure.Methods 100 patients with chronic heart failure were evaluated,they were divided into 4 groups according to NYHA.The control group was 25 healthy persons.The plasma CTGF of each groups was assayed individually.Results The result of the control group was(0.7994±0.1650)ng/ml.The result of first group was(1.1124±0.2512)ng/ml(P<0.01).The result of the second group was(1.2563±0.2983)ng/ml(P<0.01).The result of the third group was(1.2886±0.3864)ng/ml(P<0.01).The result of fourth group was(1.3539±0.3241)ng/ml(P<0.01).The plasma concentration of CTGF and other markers of fibrosis were assessed and compared with clinical and echocardiographic data.Plasma CTGF was significantly correlated with plasma brain natriuretic peptide(BNP)concentration(r=0.396,P<0.01).Plasma CTGF was also correlated with plasma transforming growth factor beta(TGF-β)(r=0.518,P<0.01),plasma CTGF was negatively correlated with E/A value evaluated by tissue Doppler echocardiography(r=-0.446,P<0.05),but not with systolic function.Conclusions Plasma CTGF concentration is a novel diagnostic marker for cardiac dysfunction.