血清Ⅲ型前胶原氨基端肽及半乳糖凝集素3在慢性心力衰竭中的临床意义

Clinical significance of serum PⅢNP and Gal-3 in chronic heart failure

目的探讨慢性心力衰竭(chronic heart failure,CHF)患者血清Ⅲ型前胶原氨基端肽(N-terminal peptide of typeⅢprocollagen,PⅢNP)和半乳糖凝集素3(galectin-3,Gal-3)的相关性,评价两者在慢性心衰中的临床意义。方法选取大连医科大学附属第二医院心内科住院的心衰患者122例作为CHF组,非心衰患者51例作为对照组。分别测定两组患者的血清PⅢNP、Gal-3和NT-proBNP水平。采用心脏彩色多普勒超声检查,测定左心室舒张末期内径(LVEDD)和左心室射血分数(LVEF)。观察CHF患者血清PⅢNP、Gal-3水平变化,探究两者之间的相关性及其分别与NT-proBNP、LVEDD、LVEF的相关性。采用多元线性回归分析的方法分析影响CHF的因素。结果CHF组患者血清PⅢNP和Gal-3水平均明显高于对照组(均P<0.01),CHF组患者PⅢNP和Gal-3水平与NT-proBNP水平正相关(分别为r=0.372,P<0.01;r=0.418,P<0.01),与LVEDD水平正相关(分别为r=0.338,P<0.01;r=0.339,P<0.01),与LVEF水平负相关(分别为r=-0.392,P<0.01;r=-0.349,P<0.01)。CHF组患者血清PⅢNP水平与Gal-3水平正相关(r=0.373,P<0.01)。多元线性回归中,Gal-3、NT-proBNP、PⅢNP是LVEF独立的影响因素(P=0.024;P<0.001;P<0.001);PⅢNP是LVEDD的独立影响因素(P=0.002)。结论PⅢNP、Gal-3水平在一定程度上可以反映CHF的严重程度及心肌纤维化情况,对评估CHF预后具有一定价值。

Objective To investigate the relationship between serum levels of N-terminal peptide of typeⅢprocollagen(PⅢNP),galectin-3(Gal-3)and cardiac functional parameters and to evaluate their clinical significance in patients with chronic heart failure(CHF).Methods A total of 122 hospitalized patients in 2 nd Affiliated Hospital of Dalian Medical University were enrolled into CHF group and 51 patients without heart failure were enrolled into control group.Venous blood was obtained for examination of NT-proBNP,PⅢNP and Gal-3.The left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were measured by echocardiography.Serum levels of PⅢNP and Gal-3 in CHF patients were measured to determine the correlation with NT-proBNP,LVEDD and LVEF respectively.Multiple linear regression analysis was used to analyze risk factors of CHF.Results The levels of serum PⅢNP and Gal-3 in CHF group were significantly higher than those in control group(P<0.01).The levels of PⅢNP and Gal-3 in CHF group were positively correlated with NT-proBNP(r=0.372,P<0.01;r=0.418,P<0.01)and LVEDD(r=0.338,P<0.01;r=0.339,P<0.01),and negatively correlated with LVEF(r=-0.392,P<0.01;r=-0.349,P<0.01).The level of serum Gal-3 in CHF group was positively correlated with PⅢNP level(r=0.373,P<0.01).Multiple linear regression analysis revealed that serum Gal-3,NT-proBNP and PⅢNP levels were independent risk factors for LVEF(P=0.024;P<0.001;P<0.001),and serum PⅢNP level was an independent risk factor for LVEDD(P=0.002).Conclusions PⅢNP and Gal-3 levels can,to some extent,reflect the severity of CHF and myocardial fibrosis,and are of value in assessing the prognosis of CHF.