慢性心力衰竭患者血清蛋白电泳的特点及其与预后的相关性分析

Analysis of Characteristics of Serum Protein Electrophoresis in Chronic Heart Failure Patients and its Correlation with Prognosis

目的：分析慢性心力衰竭（chronic heart failure，CHF）患者血清蛋白电泳（serum protein electrophoresis，SPE）的特点及与CHF预后的相关性，并初步探讨其原因。方法收集因 CHF于天坛医院心内科住院的患者68例作为研究组（CHF组），同期住院的70例心功能正常患者作为对照组，比较两组 SPE的差异。出院后电话回访 CHF患者以观察不良事件率（再住院率或死亡率）与 SPE的关系。同时分析 SPE和其它生化指标的关系来探讨 CHF患者 SPE异常的原因。结果 CHF组β1-球蛋白水平为（6.01＆#177;1.06）％，明显高于对照组（t＝3.417，P＜0.001）。CHF组β1-球蛋白≥6％的患者与＜6％的患者相比在出院后7～24个月内的事件率明显增高（P＜0.05）。多元线性回归分析显示β1-球蛋白与血肌酐、尿酸和血钠有明显相关性。结论 CHF患者 SPE中β1-球蛋白水平较心功能正常患者升高，β1-球蛋白水平升高可能增加了心衰患者的再入院率及死亡率。其原因可能与免疫活化致肾功能损伤有关。

Objectives To analyze the characteristics of serum protein electrophoresis（SPE）in chronic heart failure（CHF） patients,evaluate prognostic value and explore the reason of it preliminarily.Methods Retrospective exploration of 6 1 8 chronic heart failure patients in study cohort （CHF cohort）and 70 patients with normal cardiac function in control cohort was made to comp are the difference of serum protein electrophoresis.Then,CHF Patients were tracked down by phone to discuss the correlation between adverse event rate （re-hospitalization rate or mortality rate）and their SPE.Last,the multiple linear regression analysis of SPE and biochemical indicators was made to explore the reason of the abnormality.Results Pa-tients of CHF cohort appeared to have significantly rising beta 1-gobulin（6.01±1.06）%,compared with control cohort（t=3.417,P〈0.001）.Post-discharge adverse event rate displayed by the curve demonstrated that patients with beta 1-gobulin higher than or equal to 6% had much more adverse event rate than those with beta 1-gobulin less than 6%,in 7 to 24 months after discharged from the hospital,which had been proved by the Chi-square test of 0.031（P〈0.05）.Multiple linear regres-sion analysis showed that beta 1-globulin and serum creatinine,uric acid,and sodium were significantly correlated.Conclusion CHF patients had higher beta 1-gobulin of SPE probably because of immunoactivation,which may increase their re-hospi-talization rate ormortality rate after hospital discharge.Meanwhile,growing beta 1-gobulin is closely correlated with blood creatinine,uric acid and blood natrium and becomesa risk of kidney dysfunction due to hypoperfusion and accumulation of se-rum immunoglobulin.