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目的:探讨循环内皮细胞(circulating endothelial cells,CECs)在心力衰竭(心衰)患者左心室功能及预后评价中的临床价值。方法:入选280例明确诊断为心衰的患者(病例组)和100例表观健康人(对照组),检测研究对象的CECs计数值,通过超声心动图记录左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)、左室心肌质量指数(LVMI)及左室射血分数(LVEF);分析CECs计数值和心功能参数的关联性;随访患者不良事件的发生情况,对不同CECs计数值分组的人群做生存分析。结果:病例组的CECs计数值显著高于对照组,为(9 663±2 395)/mL对(674±224)/mL,P<0.01。CECs计数与LVEF呈负相关(r=-0.65),与LVEDVI(r=0.85)、LVESVI(r=0.68)、LVMI(r=0.63)呈正相关(P<0.01)。病例组中CECs计数高于均数组的患者再入院及死亡发生率高于CECs计数低于均数组的患者,CECs≥9 663/mL组患者的生存概率随时间的下降趋势大于CECs<9 663/mL组患者(HR=1.84,95%CI:1.26~2.67,P<0.01)。结论:心衰患者CECs计数值明显升高,CECs计数值在评估心功能及不良事件发生风险方面具有参考价值。
Objective: To investigate the clinical value of circulating endothelial cells (CECs) in the assessment of left ventricular function and prognosis in patients with heart failure (HF). Methods: Two hundred and eighty patients with definite diagnosis of heart failure (case group) and 100 healthy subjects (control group) were enrolled in the study. The CECs were measured and the left ventricular end-diastolic volume index (LVEDVI) was recorded by echocardiography. Left ventricular end-systolic volume index (LVESVI), left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) were calculated. The correlation between CECs count and cardiac function parameters was analyzed. The occurrence of adverse events in follow- Survival Analysis of Population Categorized by Counts of CECs. Results: The count of CECs in case group was significantly higher than that in control group (9 663 ± 2 395) / mL (674 ± 224) / mL, P <0.01. The counts of CECs were negatively correlated with LVEF (r = -0.65), and positively correlated with LVEDVI (r = 0.85), LVESVI (r = 0.68) and LVMI (r = 0.63) (P <0.01). The incidence of rehospitalization and death in patients with CECs higher than the mean was higher in patients with CECs than those with CECs less than the mean. The survival probability of patients with CECs ≥9 663 / mL decreased more with time than CECs <9 663 / mL group (HR = 1.84, 95% CI: 1.26-2.67, P <0.01). Conclusion: The CECs count value of patients with heart failure is significantly higher, and the CECs count value has reference value in assessing the cardiac function and risk of adverse events.