亲环素A与慢性心力衰竭相关性的研究

Study on the Relationship between Cyclophilin A and Chronic Heart Failure

目的：探讨亲环素 A（CyP A）在慢性心力衰竭中的诊断意义。方法选择经临床确诊的慢性心力衰竭患者80例，分为心衰 A期30例、心衰C期29例、心衰D期21例。同时选择健康体检者30例作为对照组。采用ELISA方法测定CyP A的含量，采用罗氏电化学发光法检测 NT-proBNP的含量。结果健康对照组及慢性心衰各组 CyP A浓度（x^-±s， ng／ml）分别为110.10±49.73，327.85±82.67，331.70±69.34和342.46±92.55。采用单因素方差分析，慢性心衰患者CyP A浓度显著高于健康对照组（F＝58.45，P＜0.01）。进一步采用 LSD检验进行组间两两比较，慢性心衰各组均显著高于健康对照组（均值差217.75-232.36，P值均＜0.01），但慢性心衰各组间的差异无统计学意义（均值差3.37-14.61， P值均＞0.05）。ROC曲线显示，CyP AAUC＝0.97，最佳临界值为198.39（ng／ml），其灵敏度为91.30％，特异度93.30％。相关性分析显示CyP A与 NT-proBNP存在显著相关性（r＝0.30，P＜0.01）。CyP A与 proBNP联合检测诊断心衰灵敏度为93.80％，特异度为100％。结论 CyP A在慢性心力衰竭患者中高表达，提示Cyp A可能是 CHF的一个显现因子，其与 NT-proBNP联合检测可能有助于心衰的诊断。

Objective To investigate the diagnostic value of cyclophilin A（CyPA）for chronic heart failure （CHF）.Methods Eighty pateints,made a definite diagnosis as CHF,were classified 30 cases as A phase,29 cases as C phase,21 cases as D phase of them.30 healthy subjects were enrolled in this study.Serum CyP A was detcted by ELISA.NT-proBNP was detected with Roche Cobas 6 000 automatic electrochemilu-minescence immunoassay system.Results The amounts of serum CyP A（x^-±s,ng/ml）in healthy subjects and each group with CHF were 110.10±49.73,327.85±82.67,331.70±69.34 and 342.46±92.55.Using Oneway Anova,CyP A concentration of CHF was significantly higher than healthy controls （F=58.45,P〈0.01）.Further using Post Hoc Tests-Multiple Comparisons,the CyP A concentration of each group with CHF was significantly higher than the healthy control group （Mean differences were 217.75-232.36,P〈0.01）,but showed no significant difference between the groups with CHFs （Mean differences were 3.37-14.61,P〉0.05）.Results of ROC curves showed the AUC （CyP A）was 0.97.The best cutoff value was 198.39 （ng/ml）.The sensitivity was 91.30%,the specificity was 93.30%.The correlation analysis showed that CyP A and NT-proBNP were correlated （r=0.30,P〈0.01）. CyP A and NT-proBNP combined detections showed the sensitivity was 93.80% and the specificity was 100%.Conclusion The Cyp A levels in CHF group are significantly higher than the control group,suggesting that Cyp A may be a factor for CHF appearance.These results indicate that combined detections may helpful to early diagnosis of CHF.