摘要
目的:应用半乳糖凝集素-3(Galectin-3,Gal-3)、N末端B型利钠肽原(NT-proBNP)和超声心动图指标,评估心力衰竭患者心功能,并比较不同指标评价心功能的能力。方法:入选2016-03至2016-11入住河北省人民医院的患者144例,根据纽约心脏协会(NYHA)心功能分级将患者分为心功能不全组72例和心功能正常组72例。收集入选者性别、年龄等临床基线资料,抽取静脉血测量血清Gal-3、血浆NT-proBNP水平以及超声心动图指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD))]。分析两组患者的基线资料,以及Gal-3、NT-proBNP和超声心动图指标之间的相关性,并比较三者判别心力衰竭患者的能力。结果:与心功能正常组比较,心功能不全组血浆NT-proBNP水平升高[3499.5(1431.3~9088.0)ng/L vs 384.1(122.1~1540.5)ng/L,P<0.05],血清Gal-3水平升高[3.0(1.71~5.8)pg/ml vs 1.9(1.4~2.6)pg/ml,P<0.05],LVEF降低[49.5%(42%~58%)vs 62.5%(59%~67%),P<0.05],LVEDD增大[52.0(46.3~57.8)mm vs 46.0(42.0~49.0)mm,P<0.05],肌酐水平升高[113.6(90.5~152.7)μmol/L vs 82.4(69.1~97.4)μmol/L,P<0.05]。相关性分析显示NT-proBNP和Gal-3与超声心动图指标(LVEF、LVEDD)之间均相关,其中Gal-3和NT-proBNP相关性(r=0.57,P<0.01)最强。受试者工作特征(ROC)曲线下面积Gal-3、NT-proBNP、LVEF分别为0.674(0.584~0.763)、0.837(0.771~0.902)、0.806(0.735~0.878)。提示NT-proBNP判别心力衰竭的能力最强。结论:Gal-3具有判别心力衰竭的能力,可以作为心力衰竭的标志物,但其判别心力衰竭的能力低于NT-proBNP。
Objective：To compare the effect of galectin-3（Gal-3）,NT-proBNP and echocardiography paramerters on assessing cardiac function in patients with chronic heart failure（HF）.Methods：A total of 144 patients treated in our hospital from 2016-03 to 2016-11 were enrolled.According to the NYHA classification,the patients were divided into 2 groups：HF group and Normal cardiac function group.n=72 in each group.Basic clinical information was collected,blood levels of Gal-3 and NT-proBNP were examined,echocardiography was conducted to measure left ventricular ejection fraction（LVEF） and left ventricular end diastolic diameter（LVEDD）.Correlations between Gal-3,NT-proBNP and echocardiography parameters were studied,the abilities of Gal-3,NT-proBNP and echocardiography for estimating HF were compared.Results：Compared with Normal cardiac function group,HF group had increased blood levels of NT-proBNP [3499.5（1431.3-9088.0） ng/L] vs [384.1（122.1-1540.5） ng/L] and Gal-3 [3.0（1.71-5.8） pg/ml] vs [1.9（1.4-2.6） pg/ml],decreased LVEF [49.5%（42%-58%）] vs [62.5%（59%-67%）],enlarged LVEDD [52.0（46.3-57.8） mm] vs [46.0（42.0-49.0） mm] and elevated serumcreatinine [113.6（90.5-152.7） umol/L] vs 82.4（69.1-97.4） umol/L],all P〈0.05.Correlation analysis showed that NT-proBNP and Galectin-3 were positively related to LVEF and LVEDD;Gal-3 and NT-Pro BNP had the strongest correlation（r=0.57,P〈0.01）.The AUC of ROC for Gal-3 was 0.674（0.584-0.763）,for NT-proBNP was 0.837（0.771-0.902） and for LVEF was 0.806,（0.735-0.878） which implied that NT-proBNP was the most powerful parameter for estimating HF.Conclusion：Gal-3 had the ability to estimate HF and could be used as a biomarker,while its ability was lower than NTproBNP in clinical practice.
作者
杨玲玲
李树仁
郝清卿
郝潇
李沙
马玉龙
张跃华
邓文浩
YANG LING-ling, LI Shu-ren, HAO Qing-qing, HAO Xiao, LI Sha, MA Yu-long, ZHANG Yue-hua, DENG Wen-hao.(Graduate School of Hebei Medical University, Shijiazhuang （050000）, Hebei, China)
出处
《中国循环杂志》
CSCD
北大核心
2018年第3期236-240,共5页
Chinese Circulation Journal
