摘要
目的:通过检测肾功能衰竭合并心力衰竭患者治疗前、后血清糖类抗原125(CA125)及N末端B型利钠肽原(NT-proBNP凌化,评价血清CA125与NT-proBNP在肾功能衰竭合并心力衰竭中诊断价值。方法:选择肾功能衰竭合并心力衰竭患者60例,按照肾小球滤过率(GFR)水平分为30 ml/min≤GFR<50 ml/min组(n=20),15ml/min≤GFR<30ml/min组(n=20)和GFR<15ml/min组(n=20),给予积极抗心力衰竭治疗,比较治疗前、后CAl25和NT-proBNP水平。对照组60例,GFR<15 ml/min,透析患者,不合并心功能不全,无恶性肿瘤及胸腹腔积液。结果:血清CA125:与对照组比较,30ml/min≤GFR<50ml/min组、15ml/min≤GFR<30 rnl/min组和GFR<15ml/min组治疗前、后(30 ml/min≤GFR<50 ml/min组降低外)均明显增高,差异均有统计学意义(P均<0.01)。30 ml/min≤GFR<50 ml/min组、15 ml/min≤GFR<30 ml/min组和GFR<15 ml/min组治疗后较治疗前明显下降,差异均有统计学意义(P均<0.01)。血清NT-proBNP:与对照组比较,30 ml/min≤GFR<50 ml/min组治疗前、后明显降低,15 ml/min≤GFR<30 ml/min组治疗后明显降低,差异均有统计学意义(P均<0.01)。30 ml/min≤GFR<50 ml/min组、15 ml/min≤GFR<30 ml/min组治疗后较治疗前明显下降,差异有统计学意义(P<0.01)。结论:尿毒症心力衰竭患者,NT-proBNP不能真实反应心力衰竭严重程度,血清CA125可以作为判断肾功能衰竭合并心力衰竭患者诊断、严重程度、预测疾病进展的实验室指标。
Objective： To assess the diagnostic value of serum level of carbohydrate antigen 125 （CA125） and plasma level of NT-proBNP in patients with renal failure （RF） combining heart failure （HF）.Methods： A total of 60 RF＋HF patients were studied. According to glomerulak ifltration rate （GFR）, the patients were divided into 3 groups： Group① , the patients with 30 ml/min≤GRF〈50 ml/min, Group② , the patients with 15 ml/min≤GRF〈30 ml/min and Group③, the patients with GRF〈15 ml/min, n=20 in each group. There was a Control group which included 60 RF patients with GRF〈15 ml/min and the patients were without AF, malignant tumor and pleural effusion. The patients with HF received active treatment, the levels of CA125 and NT-proBNP at before and after treatment were compared among different groups. Results： For CA125： Compared with Control group, the serum level of CA125 in 30 ml/min≤GRF〈50 ml/min group decreased after treatment and the other 2 RF＋HF groups were much higher either at before or after treatment, all P〈0.01. While within RF＋HF groups, CA 125 levels decreased in all 3 groups after treatment, all P〈0.01. For NT-proBNP： Compared with Control group, Group① had decreased plasma levels of NT-proBNP at either before or after treatment, Group② had decreased NT-proBNP after treatment, all P〈0.01. While within RF＋HF groups, both Group①and Group②had decreased NT-proBNP after treatment, all P〈0.01. Conclusion： Plasma NT-proBNP level could not accurately relfect the severity of heart failure in RF＋HF patients, while serum CA125 level might be used as the laboratory index for RF＋HF diagnosis and for assessment of severity and prognosis in relevant patients.
出处
《中国循环杂志》
CSCD
北大核心
2015年第4期359-362,共4页
Chinese Circulation Journal
