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目的研究不同心功能等级心力衰竭患者血半乳凝集素3(galectin-3)表达水平及其与心脏结构和功能的关系。方法选取96例慢性心力衰竭患者,按照美国纽约心脏病协会(NYHA)分级将患者分为Ⅰ级(16例)、Ⅱ级(21例)、Ⅲ～Ⅳ级(59例)。测定血清galectin-3及氨基末端脑钠肽前体(NT-proBNP)水平,用心脏彩色多普勒超声观察心脏结构和功能。对心功能Ⅲ～Ⅳ级患者给予正规抗心力衰竭治疗,于治疗前及治疗后1周测血清galectin-3和NT-proBNP水平。结果心功能Ⅲ～Ⅳ级组血NT-proBNP、galectin-3水平明显高于心功能Ⅱ级、Ⅰ级组(均P<0.05)。左心室射血分数(LVEF)≤40%组血NT-proBNP水平高于LVEF>40%组(LnNT-proBNP:8.31±1.64比7.54±1.32,P<0.05)。左心室舒张末期内径(LVEDD)>70mm组血galectin-3水平高于LVEDD 50～70mm组[(10.70±3.51)比(8.78±3.20)μg/L,P<0.05];LVEDD 50～70mm组血NT-proBNP、galectin-3水平高于LVEDD<50mm组[LnNT-proBNP(8.57±1.27)比(7.43±1.45),galectin-3(8.78±3.20)比(5.56±2.12)μg/L;均P<0.05]。相关性分析显示:galectin-3与NYHA分级、LVEDD呈正相关(rs=0.44,r=0.37,均P<0.05)。多元Logistic回归分析显示β受体阻滞剂类药物是降低galectin-3水平的因素(OR=0.073,P=0.003)。结论随着心功能恶化,血galectin-3水平逐渐升高。Galectin-3与左心室重构的进展有一定的相关性。抗心力衰竭治疗可影响galectin-3水平。
Objective To investigate the expression of galectin-3 and its relationship with cardiac structure and function in patients with heart failure and heart failure. Methods Ninety - six patients with chronic heart failure were enrolled and divided into grade Ⅰ (n = 16), grade Ⅱ (n = 21) and grade Ⅲ ~ Ⅳ (n = 59) according to the New York Heart Association (NYHA) classification. Serum levels of galectin-3 and NT-proBNP were measured. Cardiac structure and function were observed by color Doppler sonography. Normal heart failure patients with grade Ⅲ ~ Ⅳ were given anti-heart failure treatment. Serum galectin-3 and NT-proBNP levels were measured before treatment and one week after treatment. Results The levels of NT-proBNP and galectin-3 in the heart function Ⅲ ~ Ⅳ group were significantly higher than those in the cardiac function Ⅱ and Ⅰ groups (all P <0.05). The level of NT-proBNP in blood with left ventricular ejection fraction (LVEF) ≤40% was higher than that in LVEF> 40% (LnNT-proBNP: 8.31 ± 1.64 vs 7.54 ± 1.32, P <0.05). The level of galectin-3 in LVEDD> 70mm group was significantly higher than that in LVEDD 50 ~ 70mm group [(10.70 ± 3.51) vs (8.78 ± 3.20) μg / L, P <0.05] The levels of NT-proBNP and galectin-3 were higher than those of LVEDD <50mm group (LnNT-proBNP 8.57 ± 1.27 vs 7.43 ± 1.45 vs 8.78 ± 3.20 vs 5.56 ± 2.12 μg / L respectively) <0.05]. Correlation analysis showed that there was a positive correlation between galectin-3 and NYHA classification and LVEDD (rs = 0.44, r = 0.37, all P <0.05). Multivariate Logistic regression analysis showed that β-blockers were the factors that decreased the level of galectin-3 (OR = 0.073, P = 0.003). Conclusion With the deterioration of cardiac function, blood galectin-3 levels gradually increased. Galectin-3 and left ventricular remodeling progress has some relevance. Anti-heart failure treatment can affect galectin-3 levels.