摘要
目的研究血浆同型半胱氨酸(Hcy)、β_(2)-微球蛋白(β_(2)-MG)水平与扩张型心肌病患者慢性心力衰竭的相关性。方法选取2017年1月至2020年1月暨南大学附属一医院收治的96例扩张型心肌病慢性心力衰竭患者为研究对象,采用美国纽约心脏病学会(NYHA)的心功能分级方法将患者分为NYHAⅡ级组(30例)、NYHAⅢ级组(32例)和NYHAⅣ级组(34例);另选取同期该院的35例体检健康者为健康对照组。比较各组血清Hcy、β_(2)-MG水平,观察各组心功能指标左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)、左心室舒张早期最大血流速度/二尖瓣环舒张早期平均运动速度(E/e′),分析血清Hcy、β_(2)-MG水平与心功能指标的相关性,并探讨血清Hcy、β_(2)-MG对扩张型心肌病致慢性心力衰竭的诊断价值。结果NYHAⅡ级组、NYHAⅢ级组、NYHAⅣ级组血清Hcy、β_(2)-MG水平及LAD、LVEDD、LVEDV、E/e′明显高于健康对照组,LVEF明显低于健康对照组,差异均有统计学意义(P<0.05);NYHAⅡ级组血清Hcy、β_(2)-MG水平及LVEDD、LVEDV明显低于NYHAⅢ级组和NYHAⅣ级组,LVEF明显高于NYHAⅢ级组和NYHAⅣ级组,差异均有统计学意义(P<0.05);NYHAⅢ级组血清Hcy、β_(2)-MG及LVEDD、LVEDV明显低于NYHAⅣ级组,LVEF明显高于NYHAⅣ级组,差异均有统计学意义(P<0.05)。Hcy与LVEDD、LVEDV均呈正相关(r=0.560、0.406,P<0.05),与LVEF呈负相关(r=-0.484,P<0.05)。β_(2)-MG与LVEDD、LVEDV均呈正相关(r=0.428、0.526,P<0.05),与LVEF呈负相关(r=-0.620,P<0.05)。Hcy与β_(2)-MG呈正相关(r=0.345,P<0.05)。血清Hcy、β_(2)-MG对扩张型心肌病致慢性心力衰竭均有一定诊断价值,曲线下面积分别为0.739、0.706;而血清Hcy联合β_(2)-MG诊断扩张型心肌病致慢性心力衰竭的曲线下面积为0.891。结论血清Hcy、β_(2)-MG水平与扩张型心肌病患者慢性心力衰竭密切相关。
Objective To study the correlation between plasma homocysteine(Hcy)andβ_(2)-microglobulin(β_(2)-MG)levels and chronic heart failure in patients with dilated cardiomyopathy.Methods A total of 96 patients with chronic heart failure caused by dilated cardiomyopathy admitted to the First Affiliated Hospital of Jinan University from January 2017 to January 2020 were selected as the research objects,and the heart function classification method of American New York heart association(NYHA)was used to divide the patients into NYHAⅡlevel group(30 cases),NYHAⅢlevel group(32 cases)and NYHAⅣgroup(34 cases).In addition,35 healthy physical persons who were hospitalized at the same time were selected as the healthy control group.The levels of serum Hcy andβ_(2)-MG were compared,cardiac function index of left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),left ventricular diastolic early maximum average blood flow velocity/early diastolic mitral valve ring motion velocity(E/e′)were observed,the correlation between serum Hcy andβ_(2)-MG levels and cardiac function indexes was analyzed,and the diagnostic value of serum Hcy andβ_(2)-MG in chronic heart failure caused by dilated cardiomyopathy was explored.Results The serum Hcy,β_(2)-MG and LAD,LVEDD,LVEDV,and E/e′in NYHAⅡgroup,NYHAⅢgroup,NYHAⅣgroup were significantly higher than that in healthy control group,LVEF was significantly lower than that in healthy control group,and the differences were statistically significant(P<0.05).The serum Hcy,β_(2)-MG,LVEDD,and LVEDV in the NYHAⅡgroup were significantly lower than those in the NYHAⅢgroup and NYHAⅣgroup,and LVEF was significantly higher than those in the NYHAⅢgroup and NYHAⅣgroup,and the differences were statistically significant(P<0.05).The serum Hcy,β_(2)-MG,LVEDD,and LVEDV in the NYHAⅢgroup were significantly lower than those in the NYHAⅣgroup,and LVEF was significantly higher than that in the NYHAⅣgroup,and the differences were statistically significant(P<0.05).Hcy was positively correlated with LVEDD and LVEDV(r=0.560,0.406,P<0.05),and negatively correlated with LVEF(r=-0.484,P<0.05).β_(2)-MG was positively correlated with LVEDD and LVEDV(r=0.428,0.526,P<0.05),and negatively correlated with LVEF(r=-0.620,P<0.05).Hcy was positively correlated withβ_(2)-MG(r=0.345,P<0.05).Serum Hcy andβ_(2)-MG had certain diagnostic value for chronic heart failure caused by dilated cardiomyopathy,and the area under the curve was 0.739 and 0.706,respectively.The area under the curve of serum Hcy combined withβ_(2)-MG in the diagnosis of chronic heart failure caused by dilated cardiomyopathy was 0.891.Conclusion Serum Hcy andβ_(2)-MG levels are closely related to chronic heart failure in patients with dilated cardiomyopathy.
作者
郑义雄
梁培琴
李珉珉
ZHENG Yixiong;LIANG Peiqin;LI Minmin(Department of Clinical Laboratory,Dongpu District of the First Affiliated Hospital of Jinan University,Guangzhou,Guangdong 510660,China;Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Southern Medical University,Guangzhou,Guangdong 510660,China;Clinical Laboratory Center,the First Affiliated Hospital of Jinan University,Guangzhou,Guangdong 510660,China)
出处
《国际检验医学杂志》
CAS
2021年第6期695-699,703,共6页
International Journal of Laboratory Medicine
基金
广东省2017年省自筹经费类科技计划项目(2017ZC0015)。