血清和肽素及淀粉样蛋白A在扩张型心肌病与缺血性心肌病中的鉴别及评价意义

目的：研究血清和肽素（ COP）和血清淀粉样蛋白A（ SAA）水平在扩张型心肌病（ DCM）与缺血性心肌病（ ICM）中的鉴别价值及其与心衰严重程度之间的关系。方法入选对象65例，结合临床表现、心脏超声、BNP和部分患者冠脉造影检查随机分为：扩张型心肌病患者30例（ A组）、缺血性心肌病患者35例（ B组）、同期健康志愿者20例作为对照组（ C组）。测定各组的COP及SAA水平，进行对比观察。结果 A，B两组的血清COP和SAA水平明显高于C组，差异有显著性（P＜0．05）。 A组血清SAA水平高于B组（P＜0．05），A，B组COP水平差异无明显统计学意义（t＝0．452，P＞0．05）。 A，B两组中按NYHA分级分成的各亚组的血清COP水平随心衰程度加重而升高（F值分别为13．7，9．9，P＜0．05），而血清SAA水平却没有这种随心功能分级升高而递增趋势。结论血清SAA水平对扩张型心肌病与缺血性心肌病具有鉴别诊断意义，血清COP水平可以用于评估心衰的程度，成为评价心衰的一个新指标。

The Value of Copeptin and Serum Amyloid A in Identification and Assessment between Dilated Cardiomyopathy and Ischemic Cardiomyopathy

Objective To study the value of copeptin（ COP） and SAA in distinguishing DCM and ICM and the relationship between the COP and SAA levels and the severity of heart failure.Methods 65 patients were divided into two groups according to the clinical manifestations,cardiac ultrasound and CAG（ group A,30 patients with DCM;group B,35 patients with ICM ） ,another 20 healthy people as group C.The level of COP and SAA in each group were examined and compared.Results The level of COP and SAA in group A and B were much higher than that in group C （P〈0.05）.Compared with group B SAA in group A were higher（P〈0.05）,but the difference of the level of COP be-tween group A and group B was not significant.The level of COP rised with worsening heart faiure in group A and B（ F were 13.7 and 9.9,P〈0.05）,neither did SAA.Conclusion The level of SAA is valueable in the differential diagnosis between DCM and ICM.The level of COP can be viewed as a new assessment indicator of heart failure.