血清Galectin-3和脑钠肽在心脏再同步化治疗前后的变化及对近期预后的影响

The changes of plasma Galectin-3 and brain natriuretic peptide(BNP) levels and prognostic values in the heart failure patients after cardiac resynchronization therapy

目的:分析我院行心脏再同步化治疗(CRT)前后心力衰竭(心衰)患者血清半乳糖凝集素3(Gal-3)、脑钠肽(BNP)水平变化及其对近期预后的影响。方法:对本院50例心衰患者的随访资料进行分析,随访时间12个月,根据患者是否接受CRT治疗分为CRT组及对照组,采用酶联免疫法(ELISA)检测治疗前及治疗后1、3、6、12个月血清Gal-3和BNP水平,并行超声心动图检查,评估心脏功能。结果:随访至12个月,CRT组和对照组Gal-3水平无明显变化,两组BNP水平均显著下降,且CRT组显著低于对照组(P<0.05);CRT组左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)均减小(P<0.05),左室射血分数(LVEF)明显升高(P<0.05);CRT组患者心衰再入院率显著低于对照组(分别为20%、52%,P=0.019),发生心脏不良事件再入院者基础Gal-3和BNP水平更高。结论:血清Gal-3在心衰患者治疗前后无明显变化,基础Gal-3和BNP水平高者近期预后较差。

Objective：To investigate the alterations of serum Galectin-3（Gal-3 ）and brain natriuretic peptide（BNP）,and its values for predicting cardiovascular outcomes with the effect of cardiac resynchronization therapy（CRT）on the patients with heart failure.Method：A retrospective review on Fifty patients with heart failure was conducted.Patients were divided into CRT group and control group.Plasma levels of Gal-3 and BNP were detected before CRT,1,3,6 and 12 months after CRT.Result：The levels of Gal-3 did not change throughout the 12-month follow-up period.Plasma level of BNP was significantly reduced,and CRT group decreased significantly compared with control group（P〈0.05）.The left ventricular end-diastolic volume（LVEDV）and left ventricular end-systolic volume（LVESV）were decreased,while left ventricular ejection fraction（LVEF）was significantly increased in CRT group followed up to 12 months（P〈0.05）.CRT group was associated with lower adverse cardiac events compared with control group（20% vs 52%,P=0.019）.Patients with higher levels of Gal-3 and BNP were associated with a higher risk of adverse cardiac events.Conclusion：Gal-3 levels exhibited no significant change over the 12-month follow-up period.Patients with higher levels of both baseline Gal-3 and BNP were significantly more likely to be rehospitalized.