慢性心力衰竭患者血浆结缔组织生长因子的变化及意义

Plasma connective tissue growth factor levels in patients with chronic heart failure

目的：探讨血浆结缔组织生长因子（CTGF）水平的变化及其与慢性心力衰竭（CHF）的关系,分析血浆CTGF水平在评估CHF病情及预后的意义。方法：选取111例不同程度的CHF患者（CHF组）和60例健康体检者（对照组）,均行心脏超声检查,并计算左室重量指数（LVMI）,用ELISA法测定血浆CTGF、脑钠肽（BNP）、转化生长因子β1（TGF-β1）水平。结果：CHF患者血浆CTGF水平明显高于对照组（P〈0.05）,且随着NYHA分级的增加而显著升高。血浆CTGF水平与BNP、LVMI及NYHA分级显著正相关（r=0.540,P〈0.001;r=0.347,P〈0.001;r=0.386,P〈0.001）,与TGF-β1无明显相关性（r=0.052,P〉0.05）;多元逐步回归分析显示,CTGF是NYHA心功能分级的独立预测因素（P〈0.01）;Logistic回归分析显示,CTGF与CHF独立正相关（OR=1.009,95%CI：1.002~1.016）。结论：CHF患者血浆CTGF水平明显升高,与心功能不全的严重程度相关,CTGF是影响CHF病情和预后的独立危险因素。

Abstract Objective：To investigate the relationship between plasma connective tissue growth factor （CTGF） levels and chronic heart failure （CHF）, and analyze the clinical significance of plasma CTGF in assessing CHF patient＇s condition and prognosis. Method：The 111 patients with different degrees of CHF and 60 healthy subjects （control group） were selected. All of them were examined by echocardiography to calculate LVMI. PlasmaCTGF, brain natriuretic peptide （BNP）, transforming growth factor-β1 （TGF-β1） levels were measured by ELISA. Result：Plasma CTGF levels of patients with CHF were significantly higher than the control group （P〈0.05）, and plasma CTGF levels were significantly elevated in proportion to their NYHA classes. In the CHF group： univari- ate analysis showed that CTGF was significantly positively correlated with BNP, LVMI and NYHA class （r= 0. 540, P〈0. 001 ; r=0. 347, P〈20. 001; r=0. 386, P〈0. 001）, while not significantly correlated with TGF-β1 （r=0. 052, P〉0.05） ; Stepwise multiple regression analysis showed that CTGF was an independent predictor of NYHA class. Logistic regression analysis showed that CTGF was independently associated with CHF （OR- 1. 009, 95GCI： 1. 002--1. 016）. Conclusion： Plasma CTGF concentration is higher in patients with CHF, and associated with the severity of cardiac dysfunction. CTGF is one of the independent risk factors, in assessment the patient＇s condition and prognosis of CHF.