探讨CA125、NT-proBNP在慢性心力衰竭患者中危险评估的价值

To explore the value of CA125 and NT-proBNP in risk assessment of chronic heart failure

目的研究血清糖类抗原125(CA125)水平对慢性心力衰竭患者的危险评估价值,并与N末端脑钠肽前体(NT-proBNP)相比较。方法收集中山大学孙逸仙纪念医院收治的慢性心力衰竭患者284例,统计分析患者半年内再入院次数和原因、本次入院天数、血清CA125、NT-proBNP、肌酐(Cr)和心动图参数,包括左心室内径(LA)、右心室内径(RVDd)、室间隔厚度(IVSd)、左心房内径(LVDd)、左室后壁舒张期厚度(LVPWd)以及射血分数(EF%)。结果NYHAⅢ/Ⅳ级患者CA125、NT-proBNP水平以及阳性率显著高于NYHAⅠ/Ⅱ级;CA125异常升高组相较于CA125、NT-proBNP正常组以及单独NT-proBNP异常升高组,其住院天数、LA、RVDd、LVDd水平明显增高,EF%明显降低,同时患者表现出更高的半年内再入院风险(因心脏疾病)。胸腹积液或心包积液阳性的患者CA125水平显著高于阴性者(P<0.05)。结论慢性心力衰竭患者中NT-proBNP联合CA125更有利于临床对慢性心力衰竭进行危险分级以及预后风险评估。CA125异常升高提示更严重的心肌重塑状态,EF%更低,心功能代偿更差。NT-proBNP升高的同时,CA125水平升高预示更长的住院天数以及高风险的半年内再入院概率(因心血管疾病)。

Objective Study on the value of serum carbonhydrate antigen 125(CA125)level in risk assessment of patients with chronic heart failure,and compared with N-terminal pro brain natriuretic peptide(NT-proBNP).Methods A total of 284 patients with chronic heart failure admitted to Sun Yat-sen Memorial Hospital of Sun Yat-sen University were collected.The probability and reason of readmission within six months,the days of admission,serum CA125,'NT-proBNP,creatinine(Cr)and cardiac parameters,including left ventricular diameter(LA),right ventricular diameter(RVDd),Interventricular septal thickness(IVSd),left atrial diameter(LVDd),left ventricular posterior wall diastolic thickness(LVPWd)and ejection fraction(EF%)were analyzed.Results The concentration and positive rate of CA125,NT-proBNP in NYHAⅢ/Ⅳ patients were significantly higher than NYHAⅠ/Ⅱ;Compared with the group of normal CA125 and NT-proBNP,as well as the group of alone abnormal NT-proBNP,the hospitalized days(due to heart disease),the level of LA,RVDd and LVDd were significantly increased,while EF%was significantly lower;CA125 concentrations in patients with positive chest and ascites or pericardial effusion were significantly higher than those with negative.Conclusion NT-proBNP combined with CA125 is more conducived to clinical to risk classification and assess the prognosis of chronic heart failure.Elevation of CA125 indicates a more severe myocardial remodeling state,lower EF%,and poorer cardiac function compensation.NT-proBNP increased,CA125 increased simultaneously,indicate longer hospital stays and a high risk of readmission within six months(due to heart disease).