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目的 :探讨慢性心力衰竭(CHF)老年患者血、尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平与心功能恶化及预后的关系以及它与传统的肾功能标记物和心室壁压力标记物之间的相关性。方法:CHF老年患者129例,30例正常患者作为对照组。测定血浆和尿液NGAL水平,血常规、生化、左心室舒张末期内径(LVDd)、左室射血分数(LVEF),并在患者出院后随访12个月。分析血浆和尿液NGAL水平与心功能参数的相关性,多元线性回归分析影响CHF患者预后的相关因素。结果:1CHF组血浆和尿液NGAL水平分别为37.0(12.85,91.5)ng/m L和2.98(1.52,5.60)ng/m L,明显高于对照组的15.31(8.98,35.42)ng/m L和1.17(0.76,3.27)ng/m L,差异具有统计学意义,而且随着心功能分级增加,血浆和尿液NGAL水平逐渐升高,不同心功能分级组之间差异具有统计学意义(均P<0.05);2血浆和尿液NGAL水平与LVDd呈正相关(P<0.05或P<0.01),而与LVEF呈负相关(P<0.05),血浆NGAL水平与血NT-proBNP呈正相关(P<0.05);3多因素COX回归模型分析结果显示血浆和尿液NGAL水平是CHF患者再入院的独立预测因素。结论:CHF患者血浆和尿液NGAL水平明显升高,而且随着心功能分级增加,血浆和尿液NGAL水平逐渐升高,NGAL在CHF病情评估和预后预测中具有重要的临床价值。
Objective: To investigate the relationship between serum and urinary neutrophil gelatinase-associated lipocalin (NGAL) level and cardiac dysfunction and prognosis in elderly patients with chronic heart failure (CHF) and its relationship with traditional renal function markers and ventricular wall pressure Correlation between markers. Methods: 129 elderly patients with CHF and 30 normal controls were included as control group. Blood and urine NGAL levels, blood chemistry, biochemistry, left ventricular end-diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) were measured and followed up for 12 months after discharge. The correlation between NGAL levels in plasma and urine and cardiac function parameters was analyzed. Multivariate linear regression analysis was used to analyze the related factors that affected the prognosis of CHF patients. Results: The levels of NGAL in plasma and urine of 1CHF group were 37.0 (12.85,91.5) ng / m L and 2.98 (1.52,5.60) ng / m L, respectively, which were significantly higher than those of 15.31 (8.98,35.42) ng / m L And 1.17 (0.76, 3.27) ng / m L, respectively. The difference was statistically significant, and with the increase of heart function, the level of NGAL in plasma and urine increased gradually, and the difference between different cardiac function grading groups was statistically significant (P <0.05) .2 Plasma and urine NGAL levels were positively correlated with LVDd (P <0.05 or P <0.01), but negatively correlated with LVEF (P <0.05). Plasma NGAL levels were positively correlated with serum NT-proBNP <0.05) .3 The multivariate COX regression model analysis showed that plasma and urine NGAL levels were independent predictors of readmission for CHF patients. CONCLUSION: NGAL levels in plasma and urine of CHF patients are significantly increased. NGAL levels in plasma and urine are gradually increased with the increase of cardiac function. NGAL plays an important clinical role in the assessment of CHF and prediction of prognosis.