慢性心力衰竭患者血清hs-cTnT及galectin-3水平及其临床意义

Clinical Significance of Galectin-3 and Hypersensitive Cardiac Troponin T Levels in Patients with Chronic Heart Failure

目的：探讨慢性心力衰竭（chronic heart failure,CHF）患者半乳糖凝集素-3（Galactose lectin-3,galectin-3）和高敏肌钙蛋白-T（high-sensitivity cardiac troponin T,hs-cTnT）的水平,并评估其对CHF患者近期预后的预测价值。方法：选取CHF住院患者共220例,按美国纽约心脏病协会（NY-HA）心功能分级分为Ⅱ-Ⅳ级,检测患者血清galectin-3、hs-cTnT、氨基末端B型脑钠肽前体（NT-proBNP）水平和动态心电图及超声心动图变化。出院90d后随访,记录主要心脏不良事件（MACE）的发生情况。结果：CHF患者血清galectin-3、hs-cT-nT水平均随心功能分级增高而升高（P〈0.05）;相关性分析显示galectin-3与hs-c Tn T正相关（r=0.822,P〈0.05）;发生MACE组血清galectin-3、hs-c Tn T水平高于未发生MACE组[（19.9±4.42）ng/mL vs（17.4±3.46）ng/mL及（0.030±0.015）ng/mL vs（0.022±0.011）ng/mL,P均〈0.05];galectin-3≥22.885ng/mL组恶性心律失常及MACE发生率更高（分别为78.6%vs9.9%及85.71%vs 18.68%,P均〈0.05）,hs-cTnT阳性组恶性心律失常及MACE发生率亦更高（分别为24.7%vs 3.6%及33.8%vs10.7%,P均〈0.05）。结论：血清galectin-3、hs-cTnT与CHF的严重程度相关,对评估CHF患者的近期预后有重要参考价值。

Objective： To evaluate the levels of galectin-3 and hypersensitive cardiac troponin T （hs-cTnT） and examine their prognostic values in patients with chronic heart failure （CHF）. Methods： A total of 110 CHF patients with New York Heart Association （NYHA） II -1V were recruited. The serum levels of gatectin-3, hs-cTnT and N-terminal pro-brain natfiuretic peptide （NT-proBNP）, dynamic electrocardiogram and echocardiography were detected. Follow-ups were conduced within 90 days of discharge to monitor major adverse cardiac events （MACE）, readmissions or mortality. Results： The serum levels of galectin-3 and hs-cTnT rose with higher heart func-tion classification（P〈0.05）. Correlation analysis showed that galectin-3 was positively correlated with hs-cTnT （r =0.823 ,P〈0. 05）. Compared with the non-MACE group, the MACE group had higher levels ofgalectin-3 （19.9± 4.42 vs 17.4± 3.46 ng/mL, P〈0.05） and hs-cTnT （0.030± 0.015 vs 0.022± 0.011 ng/mL）. And the galectin-3 elevation group had higher incidence rates of malignant arrhythmia （78.6% vs 9.9%,P〈0.05）and MACE （85.71% vs 18.68%, P〈0.05）. The hs-cTnT positive group also had higher incidence rates of malignant arrhythmia （24.7% vs 3.6%, P〈0.05） and MACE（33.8% vs 10.7%, P〈0.05）. Conclusion： The serum levels of galectin-3 and hs-cTnT were positively correlated with the severity of CHF and had important values for predicting the short-term prognosis of CHF.