血清BNP、CA125表达在老年慢性心力衰竭预后评估中的应用

Application of Serum BNP and CA125 Expressions in Prognosis Evaluation of Elderly Patients with Chronic Heart Failure

目的检测老年慢性心力衰竭患者血清B型钠尿肽(BNP)、CA125水平,分析其与患者生存预后的关系。方法选取2013年1月至2015年1月我院收治的115例老年慢性心力衰竭(CHF)患者为研究对象,同期30例体检健康者为对照组。检测两组受试者血清BNP及CA125水平,分析两者与心功能分级的相关性;分析影响患者预后的因素,并采用受试者工作特征曲线(ROC)分析患者生存预后的效能。结果对照组血清BNP、CA125明显低于CHF组患者(P<0.05),Ⅳ级BNP水平明显高于Ⅲ级及Ⅱ级患者(q=44. 237、38.232,均P <0. 05),Ⅳ级CA125水平明显高于Ⅲ级及Ⅱ级患者(q=36.329、25.425,均P<0.05);Spearman相关性分析显示,BNP及CA125均与CHF患者心功能分级呈正相关(r_s=7. 803、5. 331,均P<0.05);单因素分析显示死亡组患者既往存在高血压史、冠心病史、伴有肾损伤、心功能分级Ⅲ～Ⅳ级分布比例明显高于生存组,差异有统计学意义(P<0.05),死亡组患者血清BNP、CA125水平明显高于生存组,血清高密度脂蛋白胆固醇(HDL-C)水平明显低于生存组,比较差异均有统计学意义(P<0.05)。进一步回归分析显示,心功能Ⅲ～Ⅳ级、血清高BNP及CA125为患者死亡的独立影响因素(P<0.05);心功能分级、血清BNP及CA125均对患者生存预后具有一定的诊断价值,联合检测诊断CHF预后的效能明显高于任一单一指标诊断。结论血清BNP、CA125在CHF患者体内水平较高,联合检测可提高诊断患者预后的效能。

A total of 115 elderly patients with chronic heart failure(CHF)admitted in our hospital from January 2013 to January 2015 were selected as the research subjects,while 30 healthy subjects in the same period as the control group.The serum BNP and CA125 levels were detected in both groups,and the correlation between them and cardiac function grading was analyzed.The factors affecting the prognosis of patients were further analyzed.The receiver operating characteristic curve(ROC)was also used to estimate the prognosis of patients.Results The serum levels of BNP and CA125 in the control group were significantly lower than those in the CHF group(P<0.05).The level of BNP in grade IV patients was significantly higher than that of gradeⅢandⅡpatients(q=44.237,38.232,all P<0.05).Compared with patients of gradeⅢandⅡ,the level of CA125 in grade IV patients was also higher(q=36.329,25.425,P<0.05);Spearman correlation analysis showed that both BNP and CA125 were positively correlated with cardiac function grading in patients with CHF(rs=7.803,5.331,all P<0.05);Univariate analysis showed that the patients in the death group had features including:a history of hypertension,a history of coronary heart disease,with renal injury,and the proportion of gradeⅢ-Ⅳin heart function was significantly higher than that in the survival group,(P<0.05).The serum levels of BNP and CA125 in the death group were significantly higher than those in the survival group,and the serum high density lipoprotein cholesterol(HDL-C)level was significantly lower than the survival group(P<0.05).Furthermore,the regression analysis showed that cardiac functionⅢ-Ⅳand serum high levels of BNP and CA125 were independent influencing factors(P<0.05).Heart function grading and serum levels of BNP and CA125 had certain diagnostic value for survival and prognosis.The efficacy of combined detection for the diagnosis of CHF prognosis was significantly higher than any single indicator diagnosis.Conclusion The expression levels of BNP and CA125 in serum are relatively higher in patients with CHF,and the combined detection of these two markers can improve the disease prognosis.