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目的探讨血清脑钠肽、糖类抗原125(CA125)水平与慢性心力衰竭患者心功能和预后的关系。方法选取2014年3月—2015年3月自贡市中医院收治的慢性心力衰竭患者127例作为病例组,根据纽约心脏病协会(NYHA)心功能分级,将其分为A(Ⅰ~Ⅱ级,n=46)、B(Ⅲ级,n=50)、C(Ⅳ级,n=31)3组;另选取同时期在本院进行体检的健康成年人60例作为对照组。比较并分析4组患者的脑钠肽(BNP)、CA125水平、心脏超声心动图检查指标,以及3个病例组患者的预后情况。结果 C组患者的血清BNP、CA125水平高于B组,B组高于A组,A组高于对照组(P<0.05)。A、B、C组患者的左心房内径(LA)高于对照组(P<0.05);B、C组患者的左心室舒张末期内径(LVEDD)高于A组和对照组(P<0.05);C组患者的左心室射血分数(LVEF)低于B组,B组低于A组,A组低于对照组(P<0.05)。Spearman秩相关分析显示,血清BNP水平与血清CA125水平和LVEDD呈正相关关系,与LVEF呈负相关关系(P<0.05);血清CA125水平与血清BNP水平和LA、LVEDD呈正相关关系,与LVEF呈负相关关系(P<0.05)。BNP≥200 ng/L患者的再住院率高于BNP<200 ng/L患者(P<0.05),CA125≥35 U/ml患者的再住院率高于CA125<35 U/ml患者。结论血清BNP、CA125水平与慢性心力衰竭患者的心功能指标具有相关关系,对患者预后具有较好的预测作用,可以作为慢性心力衰竭患者诊疗和预后的评价指标。
Objective To investigate the relationship between serum brain natriuretic peptide and carbohydrate antigen 125 (CA125) levels and cardiac function and prognosis in patients with chronic heart failure. Methods A total of 127 patients with chronic heart failure who were treated in Zigong Hospital of Traditional Chinese Medicine from March 2014 to March 2015 were selected as the case group. According to the New York Heart Association (NYHA) classification of heart function, they were divided into A (Ⅰ ~ Ⅱ, n = 46), B (Ⅲ grade, n = 50) and C (Ⅳ grade, n = 31). Another 60 healthy adults were selected as the control group. The brain natriuretic peptide (BNP) levels, CA125 levels, echocardiographic parameters and the prognosis of the three patient groups were compared and analyzed. Results The serum levels of BNP and CA125 in group C were higher than those in group B, while those in group B were higher than those in group A, and those in group A were significantly higher than those in control group (P <0.05). The left atrial diameter (LA) in group A, B and C was higher than that in control group (P <0.05). The left ventricular end-diastolic dimension (LVEDD) in group B and C were higher than that in group A and control group (P <0.05) The left ventricular ejection fraction (LVEF) in group C was lower than that in group B, while that in group B was lower than that in group A, and that in group A was lower than that in control group (P <0.05). Spearman rank correlation analysis showed that there was a positive correlation between serum BNP level and serum CA125 level and LVEDD, but negatively correlated with LVEF (P <0.05). Serum CA125 level was positively correlated with serum BNP level, LA and LVEDD, negatively correlated with LVEF Correlation (P <0.05). The rehospitalization rate in patients with BNP> 200 ng / L was higher than that in patients with BNP <200 ng / L (P <0.05), and those with CA125 ≥ 35 U / ml were higher than those with CA125 <35 U / ml. Conclusions Serum BNP and CA125 levels correlate with cardiac function in patients with chronic heart failure and have a good predictive value for the prognosis of patients with chronic heart failure, which can be used as an evaluation indicator in diagnosis and prognosis of patients with chronic heart failure.