慢性心力衰竭患者血清CA125水平与心功能的关系

目的探讨慢性心力衰竭（CHF）患者血清肿瘤相关抗原125（CA125）水平与心功能的关系。方法测定150例CHF患者血清CAl25，CAl53，CAl99，CEA，AFP及N末端脑钠肽前体（NT—proBNP）水平，通过心脏超声心动图测定左室射血分数（LVEF）。所有病例按照NYHA心功能分级标准分为心功能I～Ⅱ级组、Ⅲ级组、Ⅳ级组，根据有无合并胸腔积液、心包积液或外周水肿分为积液水肿组和非积液水肿组，根据有无合并房颤分为合并房颤组及未合并房颤组。另随机抽取心功能正常的50例健康体检者作为对照组。结果CHF患者血清CAl25水平高于对照组，Ⅳ级组血清CAl25水平明显高于Ⅲ级组，而Ⅳ级组明显高于I～Ⅱ级组。血清CAl99、CEA、AFP、CAl53水平在CHF组与对照组之间无显著性差异。CHF患者治疗前CAl25水平明显高于治疗后水平。CHF合并胸腔积液、心包积液或外周水肿患者血清CAl25水平明显高于无这些体征的患者。CHF合并房颤患者与未合并房颤患者的CAl25水平比较无显著性差异。CHF患者血清CAl25水平与NT—proBNP水平呈正相关，与LVEF呈负相关，与导致CHF的原发病种类不相关。结论血清CAl25水平随心功能恶化而升高，随心功能改善而减低，可用来评价心力衰竭严重程度、治疗疗效及短期预后。血清CAl25水平与胸腔积液、心包积液、外周水肿、NT—proBNP、LVEF有关，与房颤及导致心力衰竭的原发病种类无关。

Relationship between serum level of Carbohydrate Antigen 125 and heart function in patients with chronic heart failure

Objective It is to study the relationship between the level of serum carbohydrate antigen 125 （CA125） and heart function in patients with chronic heart failure （CHF）. Methods One hundred and fifty patients with CHF were divided into I ＋ II , III, IV groups based on stand New York Heart Association classification. The serum levels CA125, CA153, CA199, CEA, AFP and NT - proBNP were measured. Left ventricular ejection fraction （LVEF） was measured by echocardio- graphy. The incidence of pleural effusion, pericardial effusion, peripheral edema and atrial fibrillation were recorded. The pa- tients were subdivided into PF（ pleural effusion, perieardial effusion or peripheral edema） group and non -PF group based up- on the presence of pleural fluid, pericardial effusion or peripheral edema. The patients were subdivided into AF （ atrial fibrilla- tion） group and non - AF group based upon the presence of atrial fibrillation. Fifty healthy examiners without heart failure were served as control group. Results The level of CA125 in patients with heart failure was much higher than those without heart failure as control group. Mean values of CA125 were significantly higher in patients in class IV than in those patients in class ]lI, and in class m significantly higher than in class I - ]I. The level of those tumor markers including CA153, CA199, CEA, AFP were not significantly different between heart failure group and control group. The level of CA125 in pa- tients with heart failure was significantly lower by treatment. The level of CA125 in patients with pleural effusion, pericardial effusion, peripheral edema was much higher than those without ones. There was no significantly different between levels of CA125 in patients with atrial fibrillation and without atrial fibrillation. The linear correlation showed that serum CA125 in pa- tients with CHF were negatively correlated with LVEF independent of the kinds of heart disease, as well as positively correlated with NT -proBNP. Conclusion Serum CA125 in heart failure increased with the worsing of heart function, and decreased with improving of heart function, and may be used to evaluate CHF severity, changes induced by therapy,short-time prognosis. The level of CA125 is related with pleural effusion, perieardial effusion, peripheral edema, NT -proBNP and LVEF, and is inde- pendent of the kinds of heart disease and atrial fibrillation.