血清和肽素、糖链抗原125及氨基末端脑钠肽前体水平与慢性心力衰竭患者心室重构及心功能的关系研究

Relationship between Serum Level of Copeptin,of CA125,of NT-proBNP and Ventricular Remodeling,Cardiac Function in Patients with Chronic Heart Failure

目的探讨血清和肽素、糖链抗原125(CA125)、氨基末端脑钠肽前体(NT-proBNP)水平与慢性心力衰竭(CHF)患者心室重构及心功能的关系。方法选取2015年1月—2018年1月湖北省中西医结合医院收治的CHF患者80例作为CHF组,另选取同期在湖北省中西医结合医院体检健康者50例作为对照组。比较两组受试者血清和肽素、CA125、NT-proBNP水平及心室重构指标[包括左心室内径(LAD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)],不同纽约心脏病协会(NYHA)分级CHF患者血清和肽素、CA125、NT-proBNP水平;血清和肽素、CA125、NT-proBNP水平与CHF患者心室重构指标的相关性分析采用Pearson相关分析,与NYHA分级的相关性分析采用Spearman秩相关分析。结果 (1)CHF组患者血清和肽素、CA125、NT-proBNP水平高于对照组,LAD和LVEDD大于对照组,LVEF低于对照组(P<0.05)。(2)NYHA分级Ⅲ、Ⅳ级者血清和肽素、CA125、NT-proBNP水平高于NYHA分级Ⅱ级者,NYHA分级Ⅳ级者血清和肽素、CA125、NT-proBNP水平高于NYHA分级Ⅲ级者(P<0.05)。(3)Pearson相关分析结果显示,血清和肽素、CA125、NT-proBNP水平均与CHF患者LAD、LVEDD呈正相关,与LVEF呈负相关(P<0.05);Spearman秩相关分析结果显示,血清和肽素、CA125、NT-proBNP水平均与CHF患者NYHA分级呈正相关(P<0.05)。结论血清和肽素、CA125、NT-proBNP水平与CHF患者心室重构及心功能有关,可作为评估CHF患者心肌重构及心功能的重要参考指标。

Objective To investigate the relationship between serum level of copeptin,CA125,NT-proBNP and ventricular remodeling,cardiac function in patients with chronic heart failure.Methods A total of 80 patients with chronic heart failure were selected as CHF group in Hubei Integrated Traditional Chinese and Western Medicine Hospital from January 2015 to January 2018,meanwhile a total of 50 healthy volunteers were selected as control group.Serum levels of copeptin,CA125 and NT-proBNP,index of ventricular remodeling(including LAD,LVEDD and LVEF)were compared between the two groups,meanwhile serum levels of copeptin,CA125 and NT-proBNP were compared in chronic heart failure patients with different NYHA classification;Pearson correlation was used to analyze the correlations of serum levels of copeptin,CA125 and NT-proBNP with index of ventricular remodeling,meanwhile Spearman rank correlation was used to analyze the correlations of serum levels of copeptin,CA125 and NT-proBNP with NYHA classification.Results(1)Serum levels of copeptin,CA125 and NT-proBNP in CHF group were statistically significantly higher than those in control group,LAD and LVEDD in CHF group were statistically significantly larger than those in control group,while LVEF in CHF group was statistically significantly lower than that in control group(P<0.05).(2)Serum levels of copeptin,CA125 and NT-proBNP in chronic heart failure patients withⅢ-andⅣ-NYHA classification were statistically significantly higher than those in chronic heart failure patients withⅡ-NYHA classification,meanwhile serum levels of copeptin,CA125 and NT-proBNP in chronic heart failure patients withⅣ-NYHA classification were statistically significantly higher than those in chronic heart failure patients withⅢ-NYHA classification(P<0.05).(3)Pearson correlation analysis results showed that,serum levels of copeptin,CA125 and NTproBNP was positively correlated with LAD and LVEDD in patients with chronic heart failure,respectively,but was negatively correlated with LVEF,respectively(P<0.05);Spearman rank correlation analysis results showed that,serum levels of copeptin,CA125 and NT-proBNP was positively correlated with NYHA classification in patients with chronic heart failure(P<0.05).Conclusion Serum level of copeptin,CA125 and NT-proBNP are significantly correlated with ventricular remodeling and cardiac function in patients with chronic heart failure,which may be evaluation index of ventricular remodeling and cardiac function in patients with chronic heart failure.