CAJ | 학술논문

目的：观察慢性心力衰竭（CHF）患者血清N末端B型脑钠肽前体（NT-proBNP）、糖类抗原125（CA-125）、超敏C反应蛋白（Hs-CRP）的水平变化情况，探讨三者单独检测和联合检测对心力衰竭严重程度的评估价值。方法选择入住本院的C H F患者62例（C H F组），其中心功能Ⅱ级13例，心功能Ⅲ级27例，心功能Ⅳ级22例。对照组选择患其他心血管疾病患者54例。检测 CHF 组入院时及对照组人群血清 NT-proBNP、CA-125、Hs-CRP 浓度，并同时用超声心动图检测左室射血分数（LVEF）。结果 CHF组患者血浆NT-proBNP、CA-125、Hs-CRP水平均明显高于对照组（P＜0．01），随着心力衰竭严重程度的增加，NT-proBNP、CA-125、Hs-CRP水平均呈增加趋势，心功能Ⅱ级、Ⅲ级、Ⅳ级组间比较差异有统计学意义（P＜0．01）。NT-proBNP和CA-125、LVEF相关度较高（NT-proBNP vs ．LVEF ，r＝0．934，P＜0．01；CA-125 vs ．LVEF ，r＝0．878，P＜0．01），Hs-CRP和LVEF的相关度较低（r＝0．437，P＜0．05）。NT-proBNP、CA-125、Hs-CRP三者联合检测的曲线下面积（AUC）大于所有单一指标的AUC。结论 NT-proBNP、CA-125、HS-CRP三者联合检测可提高心力衰竭程度观察的价值。
목적：관찰만성심력쇠갈（CHF）환자혈청N말단B형뇌납태전체（NT-proBNP）、당류항원125（CA-125）、초민C반응단백（Hs-CRP）적수평변화정황，탐토삼자단독검측화연합검측대심력쇠갈엄중정도적평고개치。방법선택입주본원적C H F환자62례（C H F조），기중심공능Ⅱ급13례，심공능Ⅲ급27례，심공능Ⅳ급22례。대조조선택환기타심혈관질병환자54례。검측 CHF 조입원시급대조조인군혈청 NT-proBNP、CA-125、Hs-CRP 농도，병동시용초성심동도검측좌실사혈분수（LVEF）。결과 CHF조환자혈장NT-proBNP、CA-125、Hs-CRP수평균명현고우대조조（P＜0．01），수착심력쇠갈엄중정도적증가，NT-proBNP、CA-125、Hs-CRP수평균정증가추세，심공능Ⅱ급、Ⅲ급、Ⅳ급조간비교차이유통계학의의（P＜0．01）。NT-proBNP화CA-125、LVEF상관도교고（NT-proBNP vs ．LVEF ，r＝0．934，P＜0．01；CA-125 vs ．LVEF ，r＝0．878，P＜0．01），Hs-CRP화LVEF적상관도교저（r＝0．437，P＜0．05）。NT-proBNP、CA-125、Hs-CRP삼자연합검측적곡선하면적（AUC）대우소유단일지표적AUC。결론 NT-proBNP、CA-125、HS-CRP삼자연합검측가제고심력쇠갈정도관찰적개치。
Objective To investigate the changes of serum N-terminal proBNP (NT-proBNP) ,carbohydrate antigen 125(CA-125) and high sensitive CRP(Hs-CRP) levels in patients with chronic heart failure(CHF) ,to evaluate the severity of CHF using the three markers alone or in combination .Methods A total of 62 patients with CHF(CHF group) from our hospital were select-ed .Among them ,13 cases were in NYHA class Ⅱ ,27 cases were in class Ⅲ and 22 cases were in class Ⅳ .The control group in-cluded 54 patients without CHF .Serum levels of NT-proBNP ,CA-125 and Hs-CRP were detected in CHF group and control group . The left ventricular ejection fraction(LVEF) were detected by echocardiography .Results The serum levels of NT-proBNP ,CA-125 and Hs-CRP of CHF group before treatment were significantly higher than those of control group (P<0 .01) ,and the serum levels increased with the degree of severity of heart failure .There were statistically significant difference among patients in NYHA classⅡ ,class Ⅲ and class Ⅳ (P< 0 .01) .There was a high correlation between NT-proBNP ,CA-125 and LVEF (NT-proBNP vs . LVEF ,r=0 .934 ,P<0 .01 ;CA-125 vs .LVEF ,r=0 .878 ,P<0 .01) ,a low correlation between Hs-CRP and LVEF(r=0 .437 ,P<0 .05) .Compared with the single marker detection ,the combined detection of NT-proBNP ,CA-125 and Hs-CRP increased the AUC .Conclusion The combined detection of NT-proBNP ,CA-125 and Hs-CRP can increase the value of the observed severity of heart failure .