血浆半乳糖凝集素3和N末端B型钠尿肽在冠心病合并心力衰竭患者中的表达及临床意义

目的 探讨半乳凝集素-3(Gal-3)与N末端B型钠尿肽(NT-proBNP)联合检测对冠心病合并心力衰竭患者的临床意义.方法 检测2014年2月至2015年12月在武汉钢铁(集团)公司第二职工医院内科住院的318例冠心病合并心力衰竭患者(病例组)和102例正常对照者(健康组)血浆NT-proBNP、Gal-3水平,比较两组间两项标志物水平的差异,进一步分析两项标志物水平与心脏彩超参数、心功能分级之间的相关性.结果 与健康组比较,病例组患者的血浆Gal-3表达水平显著升高[(17.88±9.78)ng/mL vs(4.57±4.59)ng/mL,P<0.01],NT-proBNP水平也明显升高[(2425.03±8119.83)vs(139.46±158.75),P<0.01];Gal-3、NT-proBNP水平随心功能分级的增加而增加(P<0.001);血浆Gal-3水平与左心房内径呈正性相关(r=0.593,P<0.05),而与LVEF呈负相关(r=-0.392,P<0.05).结论 冠心病合并心力衰竭患者较健康组血浆Gal-3、NT-proBNP的水平更高,Gal-3、NT-proBNP水平升高能够客观反映心功能的下降,冠心病合并心衰患者发生发展过程中对NT-proBNP和Gal-3水平的有效监测具有重要的临床意义.

Clinical significance of NT-proBNP and Galectin 3 levels in patients with coronary heart disease combined with heart failure

Objective To explore the value of B-type natriuretic peptide precursor (NT-proBNP) and Galec-tin 3 (Gal-3) in patients with coronary heart disease combined with heart failure. Methods From Feb. 2014 to Dec. 2015, 102 controls (control group) and 318 patients with coronary heart disease combined with heart failure (study group) were selected for this study. Serum levels of NT-proBNP and Gal-3, echocardiographic parameters and grade of cardiac function were determined and compared. Results Compared with the control group, Gal-3 and NT-proBNP levels in the study group were significantly higher, (17.88 ± 9.78) ng/mL vs (4.57 ± 4.59) ng/mL for Gal-3 (P<0.001) and (2425.03 ± 8119.83) vs (139.46 ± 158.75) for NT-proBNP (P<0.001). The poorer the cardiac function, the higher NT-proBNP, Gal-3 levels (P<0.001). Pearson correlation analysis showed that the levels of Gal-3 in patients with coronary heart disease combined with heart failure was positively correlated with left atrial di-ameter (r=0.593, P<0.05), and there were significantly positive correlations among Gal-3 levels and left ventricular ejection fraction (r=-0.392, P<0.05). Conclusion NT-proBNP and Gal-3 levels were higher in patients with coro-nary heart disease combined with heart failure. What's more, higher NT-proBNP, Gal-3 levels reflects poorer cardiac function. Therefore, monitoring NT-proBNP and Gal-3 levels is helpful to the diagnosis and prognosis of coronary heart disease combined with heart failure.