BNP与CA125检测在急性心力衰竭诊断中的临床价值

Clinical value of BNP and CA125 detections in the diagnosis of acute heart failure

目的探讨B型钠尿肽（BNP）与血清糖类抗原125（CA125）在诊断急性心力衰竭中的临床价值。方法选取2015年1～12月于我院急诊科就诊的60例急性心力衰竭患者．按照纽约心脏学会（NYHA）分级，分为心功能Ⅱ、Ⅲ、Ⅳ级组，另选同期的20名健康体检者作为对照组。比较各组的BNP、CA125水平，分别与超声心动图参数做相关性分析，观察两者与随访3个月出现的恶性心血管事件（难治性心力衰竭、恶性心律失常、心源性休克及心脏性猝死）及急性心力衰竭再住院的关系。结果与对照组相比，心力衰竭患者的BNP及CA125水平显著升高，并且随着NYHA心功能分级的增高而逐渐升高，差异有统计学意义（P〈0．01）。BNP、CA125水平与左室射血分数（LVEF）呈负相关，与左室舒张末内径（LVEDD）呈正相关，与肺动脉压呈正相关。分析BNP和CA125在预测心力衰竭预后的特异性和敏感性发现，CA125比BNP能更好的预测预后。结论急性心力衰竭患者BNP、CA125水平升高，CA125可作为诊断心力衰竭的重要指标。对于预测预后具有重要意义。

Objective To explore the clinical value of B-type natriuretic peptide （BNP） and serum carbohydrate antigen 125 （CA125） in the diagnosis of acute heart failure.Methods 60 patients with acute heart failure in our hospital from January to December 2015 were selected.According to New York Heart Association （NYHA） classification,all patients were divided into cardiac function Ⅱ ,Ⅲ,Ⅳ group.Another group of 20 participants for physical examinations during the same period was selected.The level of BNP and CA125 from each group was compared.Correlation analysis was based on the values of BNP and CA125 and echoeardiographic parameters.The correlation between these indexes and adverse cardiovascular events including refractory heart failure,malignant arrhythmia,cardiogenic shock,and sudden cardiac death within three-month follow-up visits as well as re-hospitalization due to acute heart failure were obseived.Results In comparison with the control group,the level of BNP and CA125 in these heart failure patients were greatly improved and were gradually increased following NYHA classification elevating,with statistical differences （P〈0.01）.The level of BNP and CA125 have negative correlations with left ventrieular ejection fraction （LVEF）,these two indexes have positive correlations with left ventricular end diastolic diameter （LVEDD）,which have positive correlations with pulmonary artery pressure.After analyzing the specificity and sensitivity of BNP and CA125 in predicting the prognosis of heart failure,CA125 could better predict the prognosis in comparison with that by BNP.Conclusion The levels of BNP and CA125 are increasing in acute heart failure.CA125 can be considered as an important index on diagnosing heart failure, which plays important significance on predicting prognosis.