血清CA125水平在心力衰竭患者心功能分级中的应用价值

Application Value of Serum CA125 and BNP Levels in Cardiac Functional Classification of Heart Failure Patients

目的探讨血清CA125(糖类抗原125)与BNP(B型脑利钠肽)水平在心力衰竭患者心功能分级中的变化及其临床意义。方法收集118例我院201 1年1月至201 1年12月住院且诊断为心力衰竭患者数据进行回顾性统计学分析。结果与健康对照组比较,NYHAⅡ(纽约心脏病协会心功能分级)、NYHAⅢ、NYHAⅣ、心血管疾病无合并心力衰竭组四组血清CA125、BNP水平均显著高于健康对照组(P<0.01),且血清CA125与BNP水平升高与NYHA分级呈正相关。不同病因(冠心病、风湿性心脏病、高血压性心脏病、扩张型心肌病、心脏瓣膜疾病)组血清CA125、BNP水平两两比较扩张型心肌病组血清CA125水平显著高于高血压性心脏病组(P<0.05),而BNP水平在不同病因组中无统计学差异。左心室扩大组血清CA125水平显著高于正常左心室组(P<0.01);而LVEF水平显著低于正常左心室组(P<0.01)。NYHA分级有胸腔积液、心包积液、房颤组血清CA125水平均高于无上述体征组,且差异具有统计学意义(P<0.01)。血清CA125与BNP呈显著正相关(P<0.01);血清CA125与LVEF(左室射血分数)呈显著负相关(P<0.01)。结论结合血清CA125、BNP、LVEF等指标可判断HF严重程度,并为NYHA分级提供实验室辅助依据。血清CA125、BNP、LVEF等指标作为临床实验室指标,综合病因、症状、体征和其他非创伤性指标可有效监控HF的发生与发展。

Objective To investigate the changes and clinical significance of serum CA125 and BNP levels in cardiac function in patients with heart failure （HF）. Methods We enrolled 118 patients with heart failure who were admitted in our hospital from January 2011-December 2011. The data were retrospectively analyzed. Results CA125 and BNP levels were significantly higher in NYHA II, NYHA III, NYHA IV, cardiovascular disease but no heart failure group than that of the healthy control group（P〈0.01）. CA125 and BNP were positively correlated with NYHA classification. Different causes （coronary heart disease, rheumatic heart disease, hypertensive heart disease, dilated cardiomyopathy, heart valve disease） were also compared. The serum level of CA125 in the dilated cardiomyopathy group was significantly higher than that in the hypertensive heart disease group （P〈0.05）; BNP had no significant difference among different causes （P〉0.05）. CA125 in the left ventricular enlargement group was significantly higher than that in the normal left ventricle group （P〈0.01）, and the LVEF level was significantly lower than that in the normal left ventricle group （P〈0.01）. NYHA classified patients complicated with pleural effusion, pericardial effusion, atrial fibrillation had higher CA125 level than those without the above signs group, and the difference was statistically significant （P〈0.01）. Serum CA125 and BNP were positively correlated, r=0.513, and P〈0.01. CA125 and LVEF were negatively correlated, r=-0.699, and P〈0.01. Conclusion Combined measurement of serum CA125, BNP and LVEF can determine the severity of HF, and can provide laboratory basis for NYHA classification. Serum CA125, BNP, LVEF can be used as laboratory indicators, which can help effectively monitoring the occurrence and development of HF when comprehensive etiology, symptoms, signs and other non traumatic indicators are all taken into the consideration.