超声联合血清标志物诊断慢性心力衰竭的价值

Value of echocardiography combined with serum markers to diagnose chronic heart failure

目的探讨心力衰竭超声指数联合血清半乳糖凝集素-3(Gal-3)、亲环素A 在慢性心力衰竭(CHF)诊断中的的价值。方法选取2015年1月—2018 年1月唐山市工人医院收治的312 例CHF 患者作为观察组。选取同期于该院体检的60例健康人群作为对照组。根据左室射血分数(LVEF)分为收缩性组和舒张性组。根据纽约心脏病学会心功能分级(NHYA)将患者分为NHYA Ⅰ、Ⅱ、Ⅲ及Ⅳ级组。检测不同组患者心力衰竭超声指数、血清Gal-3、亲环素A 水平,分析其与心功能的相关性。结果对照组和NYHA Ⅰ、Ⅱ、Ⅲ及Ⅳ级组患者的血清Gal-3、亲环素A、心力衰竭超声指数及LVEF 比较,差异有统计学意义(P <0.05),分级越高,Gal-3、亲环素A 和心力衰竭超声指数越高。收缩性心力衰竭患者血清Gal-3、亲环素A 和心力衰竭超声指数高于舒张性心力衰竭患者(P <0.05);血清Gal-3、亲环素A、心力衰竭超声指数与LVEF 呈负相关(r=-0.635、-0.622 和-0.628,均P <0.05),与心功能NHYA 分级呈正相关(r=0.745、0.834 和0.867,均P <0.05)。结论心力衰竭超声指数联合血清Gal-3、亲环素A 检测可进一步提高慢性心力衰竭的临床诊断水平,可作为评价患者心功能的重要指标.

Objective To explore the value of heart failure ultrasound index combined with serum galectin-3 (Gal-3) and cyclophilin A in the diagnosis of chronic heart failure (CHF). Methods Totally 312 chronic heart failure (CHF) patients (observation group) admitted from January 2015 to January 2018 were classified into class Ⅰ group, class Ⅱ group, class Ⅲ group, and class IV group according to NHYA classification, and were divided into contraction type group and diastolic type group according to left ventricular ejection fraction. Sixty healthy people examined in the same period were selected as control group. The ultrasound index of heart failure combined with the serum levels of Gal-3 and cyclophilin A were measured and their correlation with cardiac function was analyzed. Results The difference in serum Gal-3, cyclophilin A, and heart rate ultrasound index between the control group and class I group, class II group, class III group, and class IV group was statistically significant (P < 0.05). And the grade was higher, the leves of Gal-3, cyclophilin A, and the heart rate ultrasound index were higher. Serum Gal-3, cyclophilin A, and heart failure ultrasound index in patients with systolic heart failure were higher than those in patients with diastolic heart failure (P < 0.05). Serum Gal-3, cyclophilin A, heart failure ultrasound index were significantly negatively correlated with LVEF (r =-0.635,-0.622,-0.628, all P < 0.05), and positively correlated with heart function NHYA grading (r =0.745, 0.834, 0.867, P < 0.05). Conclusions The detection of heart failure ultrasound index combined with serum Gal-3 and cyclophilin A can further improve the clinical diagnosis of chronic heart failure, and it can be used as an important indicator of cardiac function assessment.