血清纤维化指标对排血分数正常心力衰竭诊断意义

SERUM FIBROSIS INDEX IN THE DIAGNOSIS OF HEART FAILURE WITH NORMAL LEFT VENTRICULAR EJECTION FRACTION

目的研究血清纤维化指标在排血分数正常的心力衰竭(HFNEF)诊断中的意义。方法选取我院心内科住院病人100例,分为HFNEF组(54例)和无心力衰竭症状的冠心病病人组(对照组,46例)。采用放射免疫分析法,检测两组病人治疗前后血清中Ⅰ型前胶原(PCⅠ)、Ⅲ型前胶原(PCⅢ)、透明质酸(HA)的水平。结果 HFNEF组病人治疗前血清PCⅠ、PCⅢ和HA的水平明显高于对照组,差异有显著性(t=2.56～4.06,P<0.05);HFNEF组病人抗纤维化治疗前后血清PCⅠ、PCⅢ和HA水平比较,差异有显著性(t=5.05～6.15,P<0.05)。结论 PCⅠ、PCⅢ和HA可以作为HFNEF的辅助诊断指标;抗纤维化治疗对HFNEF病人有效。

Objective To assess the diagnostic significance of serum fibrosis indexes （SFI） in heart failure with normal ejection fraction （NEF）. Methods One hundred hospitalized patients in department of cardiology were divided into heart failure with NEF （observation group） and coronary heart disease group without heart failure （control group）. Using immunoradiometric analysis, the serum levels of type I collagen （PC Ⅰ ）, type Ⅲ collagen （PCⅢ）, and hyaluronie acid （HA） were detected in both group-before and after treatment. Results Serum PC I , PCⅢ and HA of patients in the observation group before therapy were obviously higher than that in the control group, the differences being significant （t = 2.56-4.06,P〈0.05）, and the differences of serum levels of PC Ⅰ , PCⅢ, HA, between before and after antifibrotic therapy, in the observation group were significant （t = 5.05-6.15,P〈0.05）. Conclusion PC Ⅰ , PCⅢ , and HA can be used as indexes for auxiliary diagnosis of heart failure with NEF, and antifibrotic therapy is effective for this condition.