心肌营养素1血浆水平对慢性心力衰竭诊断的临床价值研究

The Clinical Diagnostic Value of Testing Plasma Cardiotrophin-1 in Patients with Chronic Heart Failure

目的探讨检测心肌营养素1(CT-1)血浆水平对慢性心力衰竭(CHF)诊断的临床价值。方法选择74例CHF患者作为病例组,按NYHA心功能分级分组:心功能Ⅱ级24例,心功能Ⅲ28例,心功能Ⅳ22例。25例健康体检者作为对照组。对所有的研究对象用酶标免疫分析方法测定血浆CT-1浓度,酶联免疫吸附法测定脑钠肽(BNP)血浆浓度,分析CT-1和BNP血浆浓度与CHF心功能的关系。结果病例组血浆CT-1和BNP浓度明显高于对照组,病例组血浆CT-1和BNP浓度随着NYHA分级增高而逐级升高,差异有统计学意义(P<0.01)。CT-1和BNP血浆浓度与左心室射血分数呈负相关性(CT-1:r=-0.755;BNP:r=-0.684,均P<0.01)。结论血浆CT-1浓度可能是反映CHF严重程度的指标。联合测定CT-1和BNP血浆浓度对CHF的早期筛查诊断具有重要的临床价值。

Objective To investigate the clinical value of detection of plasma levels of cardiotrophin-1 （ CT-1 ） for the diagnosis of chronic heart failure. Methods 74 cases of patients with chronic heart failure （CHF） were recruited as the case group, according to the NYHA classification of cardic function, class II 24 ca- ses; class In 28 cases; class Ⅳ 22 cases; 25 healthy cases were selected as control group. All the research ob- jects were tested plasma CT-1 concentration by enzyme immunoassay,plasma levels of BNP were determined by immune fluorescence. Results The plasma CT-1 and BNP concentrations of case group were significantly high- er than those in the control group. The plasma CT-land BNP concentrationsincreased along with NYHA grade increase, the differences were significant （P 〈 0.01 ）. CT-1 and B NP plasma concentrations and left ventricular ejection fraction（LVEF） were negatively correlated（ CT-1 ： r = - 0. 755 ; BNP： r = - 0. 684, P 〈 0.01 ）. Con- duslon CT-1 plasma concentration may be an index to reflectCHF severity. Combined determination of CT-1 and BNP plasma concentrations has important clinical value in CHF early diagnosis.