CA125在冠心病所致充血性心力衰竭患者中的临床意义

Clinical Significance of CA125 in Patients with Congestive Heart Faicure Caused by Coronary Heant Disease

目的探讨血清CA125水平在冠心病所致充血性心力衰竭患者中的临床意义。方法选取于2014年12月至2015年12月我院心内科所收治的140例冠心病所致充血性心力衰竭患者作为观察组,按照NYHA心功能分级标准分为3组:NYHAⅡ级组、NYHAⅢ级组、NYHAⅣ级组。选择30例同期健康体检者作为对照组。另外根据有无合并房颤,分为合并房颤组和未合并房颤组。测定所有研究对象血清中NT-proBNP、CA125水平,应用超声心动图测量左室射血分数(LVEF)、左室内径(LVD)、左房内径(LAD)、左室后壁厚度(LVPWT)、室间隔厚度(IVST)、右心房内径(RAD)等,并根据这些数值计算左室质量(LVM)。根据患者的身高、体重计算体表面积(BSA)。结果 1血清CA125水平在冠心病充血性心力衰竭组高于对照组,差异具有统计学意义(P<0.001),且其血清浓度随着心功能级别的增高而升高。2冠心病充血性心力衰竭组患者外周血清CA125水平与NT-proBNP水平呈线性正相关(r=0.909,P<0.001)。3冠心病充血性心力衰竭组患者外周血清CA125水平与左室射血分数(LVEF)呈线性负相关(r=-0.628,P<0.001),与左房内径/体表面积(LAD/BSA)、左室内径/体表面积(LVD/BSA)、左室质量指数(LVM/BSA)呈线性正相关(r=0.547、0.435、0.343,P均<0.001)。1冠心病心力衰竭患者中,合并房颤组与未合并房颤组的血清CA125、NT-proBNP水平比较,无统计学差异(P>0.05)。结论 1冠心病充血性心力衰竭患者血清CA125水平升高。其血清水平与心力衰竭患者的心功能密切相关,心功能分级越高,其血清CA125水平升高越明显,故血清CA125可作为反映心力衰竭患者心功能损害程度的生化标志物。2冠心病充血性心力衰竭患者外周血清CA125水平与NT-proBNP、LAD/BSA、LVD/BSA、LVM/BSA呈正相关,与LVEF呈负相关,与是否同时合并房颤无关。

Objective To investigate the clinical significance of serum CA125 level in patients with congestive heart failure caused by coronary heart disease.Methods 140 patients in December 2014 to December 2015 were selected in the cardiology department of our hospital for congestive heart failure（CHF）caused by coronary heart disease（CAD）.According to NYHA classification standard,patients with CHF were divided into three groups：the NYHA Ⅱ group、NYHA Ⅲ group、NYHA Ⅳ group.At the same time,we selected 30 healthy persons as the control group.In addition,the 140 patients were classified as two groups：the combined atrial fibrillation group and the non-combined atrial fibrillation group.Serum CA125 and NT-proBNP were measured using commercial available kits.Also,we determined groups of left ventricular ejection（LVEF）、left ventricular dimensions（LVD）、left ventricular posterior wall thickness（LVPWT）、interventricular septal thickness（IVST）and right atrial dimensions（RAD）.Then,calculated the Left ventricular mass（LVM）with these numerical.Body surface area（BSA）was calculated with height and weight of patients.Results 1In group CHF,The levels of serum CA125 were higher than the control group,the difference was statistically significant（P〈0.001）and the serum concentraction increased with the increase of the levels of heart function.2In group CHF,the levels of serum CA125 were positively correlated with NT-proBNP（r=0.909,P〈0.001）.3In group CHF,the levels of serum CA125 were significantly correlated with LA/BSA、LV/BSA、LVM/BSA（r=0.547、0435、0.343,P〈0.001,respectively）,and inversely related to LVEF（r=-0.628,P〈0.001）.4In group CHF,there was no significant difference between levels of CA125 and NT-proBNP in patients with atrial fibrillation and without atrial fibrillation（P〈0.05）.Conclusion 1In group CHF,the levels of serum CA125 were higher,and closely related to the heart function.The higher classification of the heart function was,the levels of serum CA125 increased more significantly,so serum CA125 could be as the biochemical marker,reflecting the cardiac dysfunction of heart failure.2The levels of serum CA125 were positively correlated with NT-proBNP、LAD/BSA、LVD/BSA、LVM/BSA,and inversely related to LVEF.But there was no significant difference between levels of CA125 with atrial fibrillation and without atrial fibrillation.