慢性充血性心力衰竭患者血清CA125、cTnT和BNP水平变化及临床诊断意义

Changes of serum CA125,cTnT,and BNP levels in patients with chronic congestive heart failure and their clinical significance

目的 探讨慢性充血性心力衰竭患者血清糖类抗原(CA125)、心肌肌钙蛋白(cTnI)和脑钠肽(BNP)水平变化及临床意义。方法 选择2015年6月至2017年5月来本院就诊的98例CHF患者作为观察组,按照美国纽约心脏病协会(NYHA)分级标准:Ⅱ级患者45例,Ⅲ级患者33例,Ⅳ级患者20例,并选择同期于本院体检的健康者100名作为对照组。采用酶联免疫吸附法(ELISA)对两组患者血清CA125、cTnI及BNP水平进行检测,将观察组治疗前后及不同危险分级上述指标变化与对照组比较。随访观察组12个月,记录心脏事件发生情况并绘制上述指标对CHF患者预后判定的ROC曲线。结果 治疗前后观察组血清CA125、cTnI及BNP水平均高于对照组(P<0.05);治疗后,观察组上述指标均下降(P<0.05)。随着NYHA分级的增高,患者血清CA125、cTnI及BNP水平随之升高,差异均有统计学意义(P<0.05)。ROC曲线显示血清CA125、cTnI及BNP曲线下面积(AUC)分别为0.808、0.796、0.737,评估CHF患者预后能力均较好。结论 慢性充血性心力衰竭患者血清CA125、cTnI及BNP水平随危险分级的递增而升高,三者均具有一定的临床诊断及预后评估价值。

Objective To investigate the changes and clinical significance of serum carbohydrate antigen(CA125),cardiac troponin(cTnT),and brain natriuretic peptide(BNP)levels in patients with chronic congestive heart failure(CHF).Methods Ninety-eight patients with CHF who admitted to our hospital from June 2015 to May 2017 were selected as observation groups.According to the New York Heart Association(NYHA)classification criteria:45 cases of grade II,33 cases of grade III,20 cases of grade IV were enrolled in the study.And 100 healthy people who received physical examination in our hospital during the same period were selected as the control group.The levels of serum CA125,cTnI,and BNP in the two groups were detected by enzyme-linked immunosorbent assay(ELISA).The changes of the above indicators before and after treatment and different risk stratification in the observation group were compared with the control group.The observation group was followed up for 12 months.The incidence of cardiac events was recorded and the ROC curve of the above indicators on the prognosis of CHF patients were drawn.Results The levels of serum CA125,cTnI,and BNP in the observation group before and after treatment were higher than those in the control group(P<0.05);after treatment,the above indexes decreased in the observation group(P<0.05).With the increase of NYHA classification,the levels of serum CA125,cTnI,and BNP increased,with statistically significant differences(P<0.05).The ROC curve showed that the area under curve(AUC)of serum CA125,cTnI,and BNP were 0.808,0.796,and 0.737 respectively,with good ability of predicting the prognosis of patients with CHF.Conclusion The levels of serum CA125,cTnI,and BNP in patients with chronic congestive heart failure increase with the increase of risk grade.All have certain clinical diagnostic and prognostic value.