摘要
目的探讨血清胎盘生长因子(placental growth factor,PlGF)与老年慢性心力衰竭(chronic heart failure,CHF)患者血清氨基末端B型脑钠肽前体(N-terminal probrain natriuretic peptide type B,NT-proBNP)和近期预后的相关性。方法选择185例老年CHF患者为CHF组,同期选择健康体检者60例为对照组;收集受试者一般临床资料并检测血清PlGF水平;按照随访6个月时是否发生主要不良心血管事件(major adverse cardiovascular events,MACE)分为MACE组和非MACE组;应用Logistic回归方程分析PlGF与MACE的关系。结果 CHF组血清PlGF、NT-proBNP、左心室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)、左心室收缩末期内径(left ventricular end-systolic dimension,LVESD)均高于或大于对照组,左心室射血分数(left ventricular ejection fraction,LVEF)和舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度比值(E/A)均低于对照组( P < 0.05);随着NYHA心功能分级的增高,血清PlGF、NT-proBNP、LVEDD、LVESD、LVEF逐渐升高或增加,LVEF逐渐下降,E/A较Ⅱ级和Ⅲ级均下降( P < 0.05);相关分析显示LVEF与LVEDD、LVESD、NT-proBNP和PlGF呈负相关,LVEDD与LVESD、NT-proBNP、PlGF呈正相关,LVESD与NT-proBNP和PlGF呈正相关,NT-proBNP 与PlGF呈正相关。MACE组NYHA心功能分级中Ⅳ级者较多,PlGF、NT-proBNP、LVEDD均高于或大于非MACE组,LVEF和E/A均低于非MACE组( P < 0.05)。多元Logistic回归结果显示PlGF水平、NYHA分级、NT-proBNP是MACE发生的危险因素,而LVEF则是保护因素。结论血清PlGF在老年CHF患者中表达增高,随着心功能的恶化其水平显著增高,且与NT-proBNP呈正相关,这可能是近期预后不良的危险因子,应当引起临床关注。
Objective To investigate the correlation of serum placental growth factor(PlGF) and N-terminal probrain natriuretic peptide type B(NT-ProBNP) and recent prognosis of elderly patients with chronic heart failure(CHF). Methods One huandred and eighty-five elderly CHF patients in our hospital were selected as CHF group and 60 patients were selected as control group during the same period.The general clinical data and serum PlGF level were collected.The main adverse cardiovascular events(MACE) were divided into MACE group and non-mace group following 6 months of follow-up.The relationship between PlGF and MACE was analyzed by Logistic regression equation. Results Serum PlGF CHF group,NT-proBNP,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD) were higher than the control group,left ventricular ejection fraction(LVEF) and E/A were lower than the control group,comparing differences statistically significant( P < 0.05).The serum PlGF level was increased gradually( P < 0.05) with the increasing of NYHA classification.Pearson correlation analysis showed that PlGF was positively correlated with NT-proBNP presentation;serum PlGF,NYHA,NT-proBNP,LVEDD in MACE group were higher than non-mace group,LVEF and E/A were lower than non-mace group,and the difference was statistically significant( P < 0.05).Multiple Logistic regression analysis showed that PlGF level was an independent risk factor for MACE in elderly CHF patients. Conclusion Serum PlGF expression significantly higher in elderly patients with CHF,with deterioration of cardiac function level increased significantly,and positively correlated with the NT-proBNP,It may be a risk factor for poor prognosis in the near future and should be paid attention to clinically.
作者
彭雪
王文娟
牛洁婷
PENG Xue;WANG Wen-juan;NIU Jie-ting(Department of Geriatrics Medical,Cangzhou Central Hospital,Hebei Province,Cangzhou 061000,China)
出处
《河北医科大学学报》
CAS
2019年第7期768-772,共5页
Journal of Hebei Medical University
基金
沧州市科技支撑计划项目(162302162)
关键词
心力衰竭
胎盘生长因子
N端前脑钠肽
预后
heart failure
placental growth factor
N-terminal probrain natriuretic peptide type B
prognosis
