心力衰竭患者血清心锚重复蛋白和利钠尿肽的变化及临床意义

Variation and significance of cardiac ankyrin repeat protein and brain natriuretic peptide in patients with heart failure

目的：探讨心力衰竭患者血清心锚重复蛋白（CARP）水平变化及其与脑利钠尿肽（BNP）和左室射血分数（LVEF）的关系。方法：入选心力衰竭住院患者120例和健康体检者30例为研究对象。按NYHA分级将心力衰竭患者分为NYHAI～Ⅳ级4个亚组，每组30例。用ELISA法测定患者血清CARP和BNP浓度，超声心动图测量LVEF。检测CARP水平与BNP水平之间的相关性。结果：心力衰竭患者血清CARP水平较对照组明显升高[（21．24±8．30）ng／ml：（8．30±1．45）ng／ml，P〈O．051。血清CARP水平随患者NYHA分级增加而呈上升趋势，且各分级组间差异具有统计学意义（P〈0．01）。心力衰竭患者血清CARP水平与BNP呈正相关性（r=0．917，P〈0．01），与LVEF呈负相关（r=0．848，P〈0．01）。结论：血清cARP水平与心力衰竭严重程度及BNP水平呈正相关，提示CARP将有可能作为心力衰竭诊断及评估其严重程度的新的生化标志物。

Objective . To investigate the change of cardiac ankyrin repeat protein （CARP） and the correlation among CARP, brain natriuretic peptide （BNP） and left ventricular ejection fraction （LVEF） in patients with heart failure （HF）. Methods.. A total of 120 patients with heart failure （HF group） and 30 healthy individuals （control group） were enrolled in the study. According to the NYHA classification （ I - IV ） criteria, the patients with heart failure were divided into four subgroups. LVEF was determined by ultrasonic cardiography, while CARP and BNP were detected by ELISA. The correlation between CARP and BNP was analyzed. Results： The level of serum CARP in patients with heart failure was significantly higher than control subjects [（21.24±8.30）ng/ml vs （8. 30±1.45）ng/ml, P〈0.05]. The levels of serum CARP increased in parallel with NYHA functional classifi- cation, and the differences among the NYHA subgroups were significant （P〈0.01）. The levels of serum CARP was positively correlated with BNP （r= 0.917, P〈0.01）, while negatively correlated with LVEF （r = -- 0. 848, P〈0.01）. Conclusion：The level of serum CARP is positively correlated with the severity of heart failure and 13NP, which demonstrate that CARP might be a novel biomarker to assist diagnosing heart failure.