B型脑钠肽和半乳糖凝集素-3与甲状腺激素对慢性心力衰竭患者的检测及与急性心力衰竭发作的关系

Relationship between B type brain natriuretic peptide,galectin-3 and thyroid hormone in patients with chronic heart failure and acute heart failure attack

目的探讨B型脑钠肽(BNP)、半乳糖凝集素-3(Gal-3)与甲状腺激素对慢性心力衰竭(CHF)患者的检测及与急性心力衰竭发作的关系。方法选取2018年12月至2020年7月于本院心内科确诊为CHF的111例患者作为研究对象,住院期间急性加重为急性心力衰竭(AHF)者54例作为AHF组,病情逐渐好转未加重者57例作为CHF组,另选同期体检健康者55名作为对照组。检测3组血清BNP、Gal-3及游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平,并分析上述指标与AHF发作的关系。结果入院时,3组血清FT4水平比较差异无统计学意义,CHF组和AHF组血清BNP、Gal-3水平均高于对照组,FT3水平均低于对照组,差异有统计学意义(P<0.05);入院时,CHF组和AHF组血清BNP、Gal-3及FT3水平比较差异无统计学意义。发作后,AHF组血清BNP、Gal-3水平均高于CHF组,FT3水平低于CHF组,差异有统计学意义(P<0.05);两组血清FT4水平比较差异无统计学意义。Logistic回归分析结果显示,血清BNP、Gal-3水平升高、FT3水平降低均为CHF患者AHF发作的独立危险因素(P<0.05)。结论CHF患者体内存在血清BNP、Gal-3水平升高及FT3水平降低,且该变化是CHF患者AHF发作的独立危险因素。

Objective To investigate the relationship between B type brain natriuretic peptide(BNP),galectin-3(Gal-3)and thyroid hormone in patients with chronic heart failure(CHF)and acute heart failure attack.Methods 111 patients diagnosed with CHF in the Department of Cardiology of our hospital from December 2018 to July 2020 were selected as the research subjects,and 54 patients with acute exacerbation of acute heart failure(AHF)during hospitalization were selected as the AHF group,57 patients whose condition gradually improved without exacerbation were selected as the CHF group,and 55 healthy persons who underwent physical examination in the same period were selected as the control group,the levels of serum BNP,Gal-3,free triiodothyronine(FT3)and free thyroxine(FT4)in the three groups were detected,and the relationship between the above indexes and the onset of AHF was analyzed.Results On admission,there was no significant difference in serum the FT4 levels among the three groups,the levels of serum BNP and Gal-3 in the CHF group and AHF group were higher than those in the control group,and the levels of FT3 were lower than that in the control group,and the difference was statistically significant(P<0.05);on admission,there was no significant difference in the levels of serum BNP,Gal-3 and FT3 between CHF group and AHF group.After the attack,the levels of serum BNP and Gal-3 in the AHF group were higher than those in the CHF group,and the levels of FT3 was lower than that in the CHF group,and the difference was statistically significant(P<0.05).There was no significant difference in the levels of serum FT4 between the two groups.Logistic regression analysis showed that the increase of serum BNP and Gal-3 levels and the decrease of FT3 level were independent risk factors for the onset of AHF in CHF patients(P<0.05).Conclusion Serum BNP,Gal-3 levels are increased and FT3 levels are decreased in patients with CHF,and these changes are independent risk factors for AHF attack in patients with CHF.