血清糖类抗原125及脑钠肽水平对心肌梗死后心力衰竭发生及严重程度的预测价值

Predictive value of serum carbohydrate antigen 125 and brain natriuretic peptide levels in the occurrence and severity of heart failure after myocardial infarction

目的探讨血清糖类抗原125(CA125)及脑钠肽(BNP)对急性心肌梗死(AMI)患者住院期间发生心力衰竭(HF)的临床意义及预测价值。方法选取2017年1月至12月郑州人民医院心血管内科收治的AMI患者。完善血清CA125、BNP及心脏彩色超声等检查。冠状动脉灌注治疗后1周内评估患者心功能。分析血清CA125、BNP水平及心脏彩色超声各指标间的相关性。对比HF患者不同NYHA心功能分级分组间CA125、BNP、左心室射血分数(LVEF)水平。结果共有124例AMI患者入组,其中41例(33.1%)患者出现符合诊断标准的HF。血清CA125、BNP水平与LVEF呈负相关(r=-0.227,P=0.011; r=-0.569,P<0.001),CA125与BNP呈正相关(r=0.270,P=0.002)。ROC曲线显示,CA125预测AMI后HF发生的AUC为0.772(95%CI 0.679～0.864,P<0.01),BNP的AUC为0.938(95%CI 0.888～0.988,P<0.01)。41例AMI后HF患者不同NYHA分级组之间,随着NYHA分级的升高,血清CA125、BNP水平随之升高,LVEF随之下降,且组间CA125、BNP、LVEF差异均有统计学意义(P<0.001)。结论血清CA125、BNP水平对AMI后HF的发生有预测价值,并与HF的临床严重程度相关。

Aim To investigate the clinical significance and predictive value of serum carbohydrate antigen 125(CA125) and brain natriuretic peptide(BNP) in patients with acute myocardial infarction(AMI) and heart failure(HF)occurred during hospitalization.Methods AMI patients admitted to cardiovascular department of Zhengzhou People’s Hospital were selected from January to December in 2017.Serum CA125,BNP and color Doppler echocardiography were examined.Cardiac function was assessed within 1 week after coronary artery infusion therapy.The correlation among serum CA125,BNP levels and the indexes of color echocardiography were analyzed.The levels of CA125,BNP and left ventricular ejection fraction(LVEF) in different NYHA cardiac function classification groups of HF patients were compared.Results A total of 124 AMI patients was enrolled,of whom 41(33.1%) had met the diagnostic criteria for HF.Serum CA125 and BNP levels were negatively correlated with LVEF(r=-0.227,P=0.011;r=-0.569,P<0.001),and CA125 was positively correlated with BNP(r=0.270,P=0.002).The area under curve(AUC) of CA125 predicting HF occurrence after AMI was 0.772(95%CI 0.679-0.864,P<0.01),and AUC of BNP was 0.938(95% CI 0.888-0.988,P<0.01).Among different NYHA classification groups in 41 patients with HF after AMI,with the increase of NYHA classification,serum levels of CA125 and BNP increased,and LVEF decreased.The differences of CA125,BNP and LVEF among groups were statistically significant(P<0.001).Conclusion Serum levels of CA125 and BNP have predictive value for the occurrence of HF after AMI,and are correlated with the clinical severity of HF.