中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
3期
252-255
,共4页
充血性心力衰竭%CA125%N末端脑钠肽
充血性心力衰竭%CA125%N末耑腦鈉肽
충혈성심력쇠갈%CA125%N말단뇌납태
Congestive heart failure%Carbohydrate antigen-125%NT-proBNP
目的 探讨老年冠心病慢性充血性心力衰竭(CHF)患者血清CA125水平与心功能等相关因素之间的关系.方法 测定178例老年冠心病CHF患者血清肿瘤标志物CA125、癌胚抗原(CEA)、甲胎蛋白(AFP)、CA199、CA15-3、CA724以及肝肾功能和N末端脑钠肽(NT-proBNP);超声心动图测定二尖瓣舒张早期E峰最大流速(Ve)、舒张晚期A峰最大流速(Va)、Ve/Va、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)及左心室射血分数(LVEF)、左心室射血时间.所有患者根据NYHA分为Ⅰ+Ⅱ、Ⅲ、Ⅳ级3组;统计其胸腔积液、外周水肿、心房颤动的发生率.结果 (1)178例患者中血清CA125≤35 U/ml 91例,CA125中位数9.9(3.4～33.7)U/ml;＞35 U/ml 87例,中位数64.4(20.2～462.1)U/ml.CA125＞35 U/ml组NYHA心功能Ⅲ+Ⅳ级82例,Ⅰ+Ⅱ级5例;≤35 U/ml组Ⅲ+Ⅳ级7例,Ⅰ+Ⅱ级84例,组间心功能差异有统计学意义(x2=133.3,P＜0.001).CA125增高组胸腔积液、心房颤动、外周水肿的发生率高于CA125≤35 U/ml组[32.2%(28/87)、5.5%(5/91),51.7%(45/87)、9.9%(9/91),78.2%(68/87)、19.8%(18/91),P均＜0.01],NT-proBNP、LVESD、LVEF、左心室射血时间比较差异均有统计学意义[2524.0(104.0～19 308.0)、356.0(32.0～5201.1)ng/L,35(27～55)、32(26～53)mm,49%(23%～66%)、59%(42%～69%),268(210～312)、290(260～340)ms,P均＜0.05].(2)直线回归显示:血清CA125与血浆NT-proBNP、尿素氮呈正相关(r=0.3326、P=0.002,r=0.3430、P=0.002),与LVEF、左心室射血时间呈负相关(r=-0.3016、P=0.006,r=-0.3336、P=0.004).结论 老年冠心病CHF患者血清CA125随着心功能分级恶化而升高,并且与血浆NT-proBNP水平、LVEF、左心室射血时间以及有无胸腔积液、心房颤动、外周水肿等因素有关.
目的 探討老年冠心病慢性充血性心力衰竭(CHF)患者血清CA125水平與心功能等相關因素之間的關繫.方法 測定178例老年冠心病CHF患者血清腫瘤標誌物CA125、癌胚抗原(CEA)、甲胎蛋白(AFP)、CA199、CA15-3、CA724以及肝腎功能和N末耑腦鈉肽(NT-proBNP);超聲心動圖測定二尖瓣舒張早期E峰最大流速(Ve)、舒張晚期A峰最大流速(Va)、Ve/Va、左心室舒張末期內徑(LVEDD)、左心室收縮末期內徑(LVESD)及左心室射血分數(LVEF)、左心室射血時間.所有患者根據NYHA分為Ⅰ+Ⅱ、Ⅲ、Ⅳ級3組;統計其胸腔積液、外週水腫、心房顫動的髮生率.結果 (1)178例患者中血清CA125≤35 U/ml 91例,CA125中位數9.9(3.4～33.7)U/ml;＞35 U/ml 87例,中位數64.4(20.2～462.1)U/ml.CA125＞35 U/ml組NYHA心功能Ⅲ+Ⅳ級82例,Ⅰ+Ⅱ級5例;≤35 U/ml組Ⅲ+Ⅳ級7例,Ⅰ+Ⅱ級84例,組間心功能差異有統計學意義(x2=133.3,P＜0.001).CA125增高組胸腔積液、心房顫動、外週水腫的髮生率高于CA125≤35 U/ml組[32.2%(28/87)、5.5%(5/91),51.7%(45/87)、9.9%(9/91),78.2%(68/87)、19.8%(18/91),P均＜0.01],NT-proBNP、LVESD、LVEF、左心室射血時間比較差異均有統計學意義[2524.0(104.0～19 308.0)、356.0(32.0～5201.1)ng/L,35(27～55)、32(26～53)mm,49%(23%～66%)、59%(42%～69%),268(210～312)、290(260～340)ms,P均＜0.05].(2)直線迴歸顯示:血清CA125與血漿NT-proBNP、尿素氮呈正相關(r=0.3326、P=0.002,r=0.3430、P=0.002),與LVEF、左心室射血時間呈負相關(r=-0.3016、P=0.006,r=-0.3336、P=0.004).結論 老年冠心病CHF患者血清CA125隨著心功能分級噁化而升高,併且與血漿NT-proBNP水平、LVEF、左心室射血時間以及有無胸腔積液、心房顫動、外週水腫等因素有關.
목적 탐토노년관심병만성충혈성심력쇠갈(CHF)환자혈청CA125수평여심공능등상관인소지간적관계.방법 측정178례노년관심병CHF환자혈청종류표지물CA125、암배항원(CEA)、갑태단백(AFP)、CA199、CA15-3、CA724이급간신공능화N말단뇌납태(NT-proBNP);초성심동도측정이첨판서장조기E봉최대류속(Ve)、서장만기A봉최대류속(Va)、Ve/Va、좌심실서장말기내경(LVEDD)、좌심실수축말기내경(LVESD)급좌심실사혈분수(LVEF)、좌심실사혈시간.소유환자근거NYHA분위Ⅰ+Ⅱ、Ⅲ、Ⅳ급3조;통계기흉강적액、외주수종、심방전동적발생솔.결과 (1)178례환자중혈청CA125≤35 U/ml 91례,CA125중위수9.9(3.4～33.7)U/ml;＞35 U/ml 87례,중위수64.4(20.2～462.1)U/ml.CA125＞35 U/ml조NYHA심공능Ⅲ+Ⅳ급82례,Ⅰ+Ⅱ급5례;≤35 U/ml조Ⅲ+Ⅳ급7례,Ⅰ+Ⅱ급84례,조간심공능차이유통계학의의(x2=133.3,P＜0.001).CA125증고조흉강적액、심방전동、외주수종적발생솔고우CA125≤35 U/ml조[32.2%(28/87)、5.5%(5/91),51.7%(45/87)、9.9%(9/91),78.2%(68/87)、19.8%(18/91),P균＜0.01],NT-proBNP、LVESD、LVEF、좌심실사혈시간비교차이균유통계학의의[2524.0(104.0～19 308.0)、356.0(32.0～5201.1)ng/L,35(27～55)、32(26～53)mm,49%(23%～66%)、59%(42%～69%),268(210～312)、290(260～340)ms,P균＜0.05].(2)직선회귀현시:혈청CA125여혈장NT-proBNP、뇨소담정정상관(r=0.3326、P=0.002,r=0.3430、P=0.002),여LVEF、좌심실사혈시간정부상관(r=-0.3016、P=0.006,r=-0.3336、P=0.004).결론 노년관심병CHF환자혈청CA125수착심공능분급악화이승고,병차여혈장NT-proBNP수평、LVEF、좌심실사혈시간이급유무흉강적액、심방전동、외주수종등인소유관.
Objective To assess the association between serum levels of carbohydrate antigen 125 (CA125) and the heart function in the elderly with congestive heart failure (CHF). Methods CA125, carcinoembryonic antigen (CEA) ,alpha-fetoprotein ( AFP), CA199, CA15-3, CA724, liver and kidney function and NT-proBNP were measured in 178 patients with heart failure. Ve, Va, Ve/Va, left ventricular end-diastolic diamete ( LVEDD), left ventricular end-systolic diamete ( LVESD ), left ventricular ejection fraction ( LVEF ) and time were measured using echocardiograph. All patients were classified as Ⅰ + Ⅱ , Ⅲ and Ⅳ level according to the criteria of New York Heart Assocation ( NYHA), and the incidence of pleural effusion, peripheral edema,atrial fibrillation were observed. Results Among the 178 patients,serum CA125 were ≤35 U/ml in 91 patients with median of 9.9( 3.4 - 33.7 ) U/ml, ＞ 35 U/ml in 87 patients with median of 64. 4 ( 20. 2 - 462. 1 ) U/ml.Among those patients with CA125 ＞ 35 U/ml ,heart function was classified as level Ⅲ + Ⅳ in 82 patients,and level Ⅰ + Ⅱ in 5 patients. Among the patients with CA125 ≤35 U/ml,heart function was classified as level Ⅲ + Ⅳin 7 patients,and level Ⅰ + Ⅱ in 84 patients. Heart function was significantly different between the two CA125 groups( x2= 133. 3 ,P ＜0. 001 ). The incidence of pleural effusion,atrial fibrillation ,peripheral edema in the higher CA125 group were 32. 2%, 51.7% and 78. 2%, respectively, which were significantly higher than those in the normal CA 125 group ( 5.5 %, 9. 9% and 19. 8 %, repactively ) ( P ＜ 0. 01 ). NT-proBNP, LVESD,LVEF and time in the higher CA125 group were 2524. 0( 104.0 - 19 308. 0) ng/L,35 (27 -55) mm,49% (23%-66% ) and 268 (210 -312)ms, which were significantly differenct from those in the normal CA125 group [356.0 ( 32.0 - 5201.0) ng/L, 32 ( 26 - 53 ) mm, 59% ( 42% - 69% ) and 290 ( 260 - 340 ) ms, respectively](Ps ＜0. 05). The linear regression showed that serum CA125 was positively correlated with NT-ProBNP and urea nitrogen ( BUN ) ( r= 0. 3326 and 0. 3430, Ps= 0. 002 ) , as well as negtively correlated with LVEF and time (r= -0. 3016,P =0. 006;r = -0. 336,P =0. 004). Conclusion Serum CA125 in the elderly with congestive heart failure increased with the worsing of heart function, and correlated with the level of NT-proBNP, LVEF and time,as well as pleural effusion, atrial fibrillation, peripheral edema.
