血清心型脂肪酸结合蛋白在风湿性心脏病患者心功能评估中的应用价值

Value of serum heart fatty acid binding protein in the assessment of cardiac function in patients with rheumatic heart disease

目的探讨血清心型脂肪酸结合蛋白(H-FABP)在风湿性心脏病(RHD)患者心功能评估中的应用价值。方法选择2016年1月至2016年12月在新乡医学院第一附属医院住院治疗的45例RHD患者作为观察组,另选取45例同期常规体检的心功能正常者为对照组,比较各组受试者血清H-FABP、B型钠尿肽(BNP)水平及左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF),并分析RHD患者血清H-FABP与血清BNP及心功能分级的相关性。结果观察组患者血清H-FABP、BNP水平及LVEDD和LVESD显著高于对照组(P<0.05),LVEF显著低于对照组(P<0.05)。心功能Ⅱ、Ⅲ、Ⅳ级RHD患者血清H-FABP、BNP水平及LVEDD、LVESD和LVEF比较差异有统计学意义(P<0.05);心功能Ⅲ、Ⅳ级RHD患者血清H-FABP、BNP水平及LVEDD和LVESD均显著高于心功能Ⅱ级患者(P<0.05),LVEF水平显著低于心功能Ⅱ级患者(P<0.05);心功能Ⅳ级RHD患者的血清HFABP、BNP水平及LVEDD和LVESD均显著高于心功能Ⅲ级患者(P<0.05),LVEF水平显著低于心功能Ⅲ级患者(P<0.05)。观察组患者血清H-FABP水平与BNP、LVEDD和LVESD水平呈正相关(r=0.579、0.743、0.740,P<0.05),与LVEF水平呈负相关(r=-0.801,P<0.05)。结论 RHD患者血清H-FABP水平随心力衰竭的加重而升高,可以作为评估该疾病患者心功能及预后的重要指标之一。

Objective To investigate the value of the serum heart fatty acid binding protein(H-FABP) in the assessment of cardiac function in patients with rheumatic heart disease( RHD). Methods Forty-five RHD patients hospitalized in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to December 2016 were selected as the observation group. In addition,45 subjects with normal cardiac function in the same period were selected as control group. The levels of serum H-FABP,B-type natriuretic peptide( BNP),left ventricular end-diastolic dimension( LVEDD),left ventricular end-systolic dimension(LVESD) and left ventricular ejection fraction( LVEF) were compared in the groups. The correlation between serum H-FABP and BNP,cardiac function classification was analyzed. Results The serum H-FABP and BNP levels and LVEDD,LVESD in the observation group were significantly higher than those in the control group( P < 0. 05),but the LVEF in the observation group was significantly lower than that in the control group( P < 0. 05). There were significant differences in the serum H-FABP,BNP levels and LVEDD,LVESD,LVEF among the patients with class Ⅱ,Ⅲ and Ⅳ of heart function( P <0. 05). The serum H-FABP,BNP levels and LVEDD,LVESD in the patients with class Ⅲ and Ⅳ of heart function were significantly higher than those in the patients with class Ⅱ of heart function( P < 0. 05); but the LVEF in the patients with class Ⅲand Ⅳ of heart function was significantly lower than that in the patients with class Ⅱ of heart function( P < 0. 05). Compared with the patients with class Ⅲ of heart function,the serum H-FABP,BNP levels and LVEDD,LVESD in the patients with classⅣ of heart function were significantly higher( P < 0. 05); but the LVEF in the patients with class Ⅳ of heart function was significantly lower( P < 0. 05). The serum H-FABP level was positively correlated with serum BNP level,LVEDD and LVESD in the observation group( r = 0. 579,0. 743,0. 740; P < 0. 05). but it was negatively correlated with LVEF( r =-0. 801,P <0. 05). Conclusion The serum H-FABP level increases with the aggravation of heart failure in patients with RHD. It can be used as an important index to evaluate the heart function and prognosis of RHD patients.