慢性心衰患者血清CA125水平测定及其临床意义

目的观察慢性充血性心力衰竭(CHF)患者血清CA125水平与心功能之间的关系。方法对75例慢性CHF患者按纽约心功能分级分组,另选正常对照20例,用酶联免疫法测定血清CA125水平,并通过超声心动图测定左室内径及射血分数。结果慢性CHF患者血清CA125水平高于对照组(11.16±6.84,P<0.05)。其升高水平与心功能恶化程度呈正相关,心功能Ⅱ级为30.52±8.26,Ⅲ级为52.84±20.01,Ⅳ级为207.4±110.4,各组间比较有非常显著的差异(P<0.001)。CHF患者左室正常组和左室增大组血清CA125水平均高于对照组(P<0.05)。左室增大组(179.64±120.25)显著高于左室正常组(36.00±42.02,P<0.001)。结论慢性CHF患者血清CA125水平升高。后者可作为判断心功能恶化的一项指标。     

慢性心力衰竭患者血清CA125检测的临床意义

慢性心力衰竭（CHF）是由于心肌损伤引起心肌结构和功能的变化，最后导致心室泵血功能低下。CHF是一种复杂的临床症状群，是各种心脏病的严重阶段，其发病率高，5年存活率与恶性肿瘤相仿。在其他心血管病得到良好控制的同时，CHF的患病率和死亡率居高不下，已经成为21世纪心血管病最后未被攻克的堡垒。     

心力衰竭患者血清CA125、CA19-9水平变化及意义

目的探讨慢性心衰(CHF)患者血清CA125、CA19-9水平变化及意义。方法(1)研究对象与分组:心衰组(CHF),按AHA指南标准随机人选17例慢性心衰患者,心功能Ⅱ-Ⅳ级(NY-HA),年龄36-86(51.7±13.2)岁。其中风湿性心脏病4例,高血压6例,冠心病5例,贫血性心脏病1例,其他1例;在这17例病例中合并心包积液2例、胸腔积液1例、心房纤颤3例,左心房及静脉血栓1例;非心衰组(NHF),冠心病(非心衰者)、高血压Ⅰ期患者13例,年龄21-77岁,健康对照组(Control),健康成年人15例,年龄25-73岁;(2)CA125、CA19-9测定:抽取清晨空腹静脉血5ml,化学发光免疫法测定血清CA125、CA19-9水平。同时,检测肿瘤三项(CEA、AFP、SF)、胸片、头颅CT以及腹部、盆腔超声,排外潜在的肿瘤;(3)统计学分析:数据采用均数±标准差(x±s)表示,t检验,P<0.05有统计学意义。结果与非心衰组和健康对照组比较,心衰组血清CA125显著升高,且与心衰严重程度(Ⅱ、Ⅲ、Ⅳ级)相关(分别P<0.01,P<0.001,P<0.001);非心衰组与健康对照组比较,无显著差别(P>0.05)。然而,各组间CA19-9水平无显著变化(P>0.05)。同时,发现合并心包、胸腔积液,尤其慢性房颤者,CA125显著升高。结论CA125是诊断和评价慢性心衰的一个良好指标,且与心衰程度相关,而CA19-9与心衰无明显关系。     

慢性心力衰竭患者血清CA125测定的临床意义

目的探讨慢性心力衰竭(CHF)患者血清糖类抗原125(CA125)与心功能之间的关系。方法 62例(男38例、女24例)CHF患者根据纽约心功能分级标准分为Ⅱ级、Ⅲ级、Ⅳ级组;根据左室射血分数(LVEF)值分为≥50%组、49%～35%组、≤35%组。另选正常对照组20例(男8例、女12例)。采用微粒子酶免疫化学发光法(META)测定血清CA125水平,超声心动图测定LVEF。结果 CHF患者各组血清CA125水平随心功能恶化程度的增加而升高,心功能Ⅱ级为(22.84±11.48)U/mL,Ⅲ级为(50.65±26.88)U/mL,Ⅳ级为(185.46±105.60)U/mL,均较对照组(9.64±3.06)U/mL升高(P<0.05),各组间比较差异有统计学意义(P<0.05);随着LVEF的降低,血清CA125水平升高。结论慢性心力衰竭患者血清CA125升高,其变化程度对评价心功能程度有一定的参考价值。     

慢性心力衰竭患者血清BNP、CA125、尿酸水平变化及临床意义

目的观察慢性心力衰竭(CHF)患者血清B型脑钠肽(BNP)、糖类抗原CA125(CA125)、尿酸(UA)水平与心功能的关系及临床意义。方法将79例CHF患者按心功能分为Ⅱ、Ⅲ、Ⅳ级组,另外随机选择心功能正常的心血管病患者30例作为对照组,测定入院时及心力衰竭控制好转后BNP、CA125、UA水平。结果 CHF患者BNP、CA125、UA浓度增高,升高与心功能分级有关;治疗后各指标明显下降。结论 BNP、CA125、UA水平可作为CHF患者诊治及判断预后的有效指标。     

老年慢性心力衰竭患者BNP和CA125表达的临床意义

目的探讨老年慢性心力衰竭(CHF)患者中B型钠尿肽(BNP)和糖类抗原(CA)125的表达情况及两者的关联性。方法采用回顾性分析,选择老年CHF患者100例作为观察组,同期门诊健康体检的老年人100例作为对照组。选择BNP、CA125等可能和CHF相关的生化指标进行单因素分析,然后将单因素分析有意义的指标进行非条件多因素Logistic回归分析,同时将BNP和CA125进行相关性分析。结果血清总胆红素(TBIL)、BNP、CA125及尿酸在两组间差异有统计学意义(P0.05),非条件二分类Logistic多因素回归分析显示BNP和CA125是老年CHF的独立危险因素(P0.001)。CHF患者中CA125和BNP的表达呈正相关(r=0.650,P0.05)。结论 BNP和CA125均为CHF的诊断独立影响因素。     

血清CA125水平与充血性心力衰竭关系初探

目的探讨充血性心力衰竭(CHF)患者血清中CA125水平与心功能的关系。方法169例CHF患者符合纽约心脏病学会心功能分级标准,分为心功能Ⅱ~Ⅳ级组,根据超声心动图检查结果,将入选者分为左心室(左室)正常组(左室舒张末期容积≤55 mm)和左室增大组(左室舒张末期容积>55 mm)。用免疫放射分析法测定血清CA125水平。并选择20名正常人作为对照组。结果CHF患者CA125血清浓度明显高于正常对照组(P<0.01),心功能Ⅲ、Ⅳ级的血清浓度高于Ⅱ级(P<0.01)。左室增大组较左室正常组CA125血清浓度显著升高(P<0.01),CA125的血清浓度与心力衰竭患者的CHF严重程度和心脏左室增大呈正相关(P<0.01)。结论CA125可能是又一个与CHF相关的非创伤性指标。     

老年心力衰竭患者血清CA125水平的变化及意义

目的探讨CA125在老年心力衰竭患者中的水平及意义。方法 220例老年心力衰竭患者,按纽约心功能分级标准分组,入院24 h内测定血清CA125和血浆B型利钠肽(BNP)的浓度并比较各组CA125、BNP浓度及其与心功能分级的相关性;分别按100 pg/ml、35 U/ml标准,比较BNP、CA125诊断心力衰竭的灵敏度;将患者分为高CA125(≥35 U/ml)组和低CA125(<35 U/ml)组,比较两组住院死亡率;联合CA125和BNP水平分组,C1=CA125<35 U/ml和BNP<350 pg/ml,C2=CA125≥35 U/ml和BNP<350 pg/ml,C3=CA125<35 U/ml和BNP≥350 pg/ml,C4=CA125≥35U/ml和BNP≥350 pg/ml,比较各组住院死亡率,运用Logistic回归分析死亡相关因素。结果 CA125和BNP浓度随心功能分级增高而升高,与心功能分级呈正相关(r=0.277和0.349,P=0.000);CA125和BNP诊断心力衰竭的灵敏度分别是36.3%和85.9%;高CA125组和低CA125组患者住院死亡率分别为20.0%和3.6%,C1~C4各组住院死亡率分别为1.8%,0%,4.9%及22.9%,P<0.05;多因素Logistic回归分析显示CA125和BNP是死亡独立危险因素(OR=2.354,P=0.025和OR=2.236,P=0.024)。结论血清CA125对心力衰竭的诊断价值不及BNP,但CA125是心力衰竭患者预后独立危险因素,BNP联合CA125测定有助于老年心力衰竭患者的预后评估。     

慢性心力衰竭病人外周血清CA125水平与BNP水平及心功能的相关性分析

目的分析慢性心力衰竭病人外周血清糖类抗原125(CA125)水平与B型钠尿肽(BNP)水平及心功能的相关性。方法收集我院2015年7月—2017年8月收治的慢性心力衰竭病人66例,根据美国纽约心脏病协会(NYHA)心功能分级标准分为Ⅰ级组~Ⅱ级组、Ⅲ级组、Ⅳ级组,每组22例。分析对比每组CA125水平情况,及其与BNP水平、心功能的相关性。结果血清CA125水平随心力衰竭分级增高而呈明显增高趋势,Ⅲ级组CA125水平、BNP水平均分别高于Ⅰ~Ⅱ级组(P<0.05),左室射血分数(LVEF)低于Ⅰ~Ⅱ级组(P<0.05);Ⅳ级组CA125水平、BNP水平、明显高于Ⅰ~Ⅱ级、Ⅲ级组(P<0.05),LVEF低于Ⅰ~Ⅱ级组(P<0.05),3组间左心室舒张末期内径(LVEDD)及左心房内径(LA)指标对比差异无统计学意义(P>0.05)。CA125与BNP呈正相关,与LVEF呈负相关,与LVEDD及LA无明显相关性。结论慢性心力衰竭病人血清CA125含量与心力衰竭的严重程度密切相关,可作为临床诊断及评估预后的一项指标。     

血清肿瘤抗原CA125水平与慢性心力衰竭关系的初步探讨

目的:探讨慢性心力衰竭(CHF)患者肿瘤抗原CA125(简称CA125)水平与患者心功能之间的关系。方法:108例CHF患者通过B型超声心动图测定左心室内径及射血分数并探察是否有胸腔积液,以酶联免疫吸附法测定其血清CA125水平,所有病例根据纽约心功能分级标准分为Ⅱ、Ⅲ、Ⅳ级组,根据有无胸腔积液而分为胸腔积液患者和非胸腔积液患者。另随机抽取40例有心血管疾病但无CHF的患者作为对照组。结果:CHF患者血清CA125水平高于对照组,Ⅳ级组血清CA125水平明显高于Ⅲ级组且Ⅲ级组明显高于Ⅱ级组,血清CA125水平与左心室射血分数值呈负相关,而与导致CHF的原发病种类不相关。胸腔积液患者血清CA125水平明显高于非胸腔积液患者,非胸腔积液患者明显高于对照组。结论:①CHF患者血清CA125水平升高,其水平与左心室射血分数呈负相关,而与导致CHF的原发病种类不相关;②胸腔积液患者其血清CA125水平高于非胸腔积液患者,这可能是由于胸膜间皮细胞分泌增加或胸腔积液刺激血清CA125的释放及阻碍其清除有关;③血清CA125水平的测定可能可以用来评价CHF治疗的疗效并可能用来评价预后。     

The significance of CA125 levels in patients with chronic congestive heart failure. Correlation with clinical and echocardiographic parameters

OBJECTIVE: To assess serum levels of carbohydrate antigen 125 (CA125) in patients with chronic congestive heart failure (CHF) and to assess any correlation with clinical symptoms and echocardiographic indices. PATIENTS AND METHODS: We enrolled 77 male patients (mean age: 73+/-10 years) admitted to the Cardiology Emergency Department (ED) with cardiac symptoms requiring hospitalization. Diagnosis of CHF was based upon medical history or initial echocardiographic evaluation on current admission. Serum CA125 was measured by an enzyme immunoradiometric assay, on admission and before discharge. RESULTS: The median overall CA125 value was 22.4 (11.5-48.9) U/ml. Serum CA125 levels were related to the severity of CHF [New York Heart Association (NYHA) class I: 19.2 (7.2-31) U/ml, NYHA class II: 17.6 (10-23) U/ml, NYHA class III: 32 (25-77) U/ml and NYHA class IV: 34.3 (18.6-77) U/ml (p<0.04)]. Patients in NYHA classes III and IV had significantly higher mean values of CA125, than patients in class II (p<0.005 and p<0.05, respectively). Moreover, patients with fluid congestion (pulmonary congestion, ankle edema) had higher levels of serum CA125 than patients without congestion (p=0.002 and p<0.03, respectively). Finally, levels of serum CA125 correlated weakly with right ventricular systolic pressure (RVSP) and renal function, while no significant correlation was found between CA125 and E wave deceleration time on Doppler echocardiography, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), liver function and the medical treatment prescribed. CONCLUSION: Serum CA125 is associated with the clinical severity of CHF and the symptoms and signs of fluid congestion and therefore may be a useful additional tool for the evaluation and clinical staging of these patients.     

Elevated carbohydrate antigen 125 levels in hypertrophic cardiomyopathy patients with heart failure

Carbohydrate antigen 125 (CA 125), known as a tumor marker for ovarian cancer, has been reported to increase and relate to severity in heart failure patients with systolic dysfunction. Hypertrophic cardiomyopathy (HCM) has a wide clinical spectrum that often includes heart failure symptoms. The aim of this study was to evaluate the role of CA 125 in HCM patients, its relation to severity of symptoms, and degree of diastolic dysfunction. CA 125 blood levels were determined in 32 HCM patients (21 male; age 51.3 +/- 18.4 years) and in 30 healthy volunteers (19 male; age 49.6 +/- 16.1 years). Echocardiographic examinations were performed in all patients. The results were grouped according to clinical status (New York Heart Association class) of the patients. The mean serum level of CA 125 was 14.6 +/- 23.8 U/ml in the study group and 7.6 +/- 4.8 U/ml in the control group. There was no significant difference between the groups (P = 0.12). CA 125 levels increased as the New York Heart Association functional class increased (class I/II: 6.2 +/- 2.4 U/ml; class III: 30.6 +/- 36.4 U/ml; P < 0.001). The mean CA 125 level in functional class III patients (30.6 +/- 36.4 U/ml) was significantly higher than that of the control group (7.6 +/- 4.8 U/ml) (P < 0.001) and the functional class I/II group (6.2 +/- 2.4 U/ml) (P < 0.001). There was a significant difference over all three diastolic dysfunction groups with respect to CA 125 levels (4.9 +/- 1.3 U/ml in impaired relaxation group, 11.8 +/- 6.9 U/ml in pseudonormal group, and 52.6 +/- 45.6 U/ml in restrictive filling group; P < 0.0001). Serum CA 125 is related to the clinical severity of HCM. Whether CA 125 has a specific biological role in HCM requires further investigation.     

血清糖类抗原125及血浆尿钠肽水平与充血性心力衰竭的关系

目的:探讨慢性充血性心力衰竭(CHF)患者糖类抗原125(CA125)及B型尿钠肽(BNP)水平与患者心功能及其相关因素之间的关系。方法:108例CHF患者通过B超测定左室内径及左室射血分数(LVEF),以酶联免疫吸附法(ELISA)测定其血清CA125水平,以BiositeTriage快速诊断仪测定其血浆BNP水平,所有患者根据纽约心功能分级标准分为Ⅱ、Ⅲ、Ⅳ级组。另随机抽取40例有心血管疾病但无CHF的患者作为非CHF组。结果:①CHF组血清CA125及BNP水平高于非CHF组,Ⅳ级心功能组水平明显高于Ⅲ级组,且Ⅲ级组明显高于Ⅱ级组;②血清CA125及BNP水平均与LVEF呈负相关,而与导致CHF的原发病种类不相关。结论:CHF患者血清CA125及BNP水平升高,并且其水平与LVEF有关,而与导致CHF的原发病种类无关。     

胰腺癌患者血清CEMIP、CA19-9和CA242水平变化及其临床意义*

目的 研究胰腺癌患者血清CEMIP、CA19-9和CA242水平变化及其临床意义。方法 2013年4月～2016年8月我院诊治的92例胰腺癌患者、105例胰腺良性疾病患者和选择的83例健康人，采用ELISA法检测血清细胞迁移诱导透明质酸结合蛋白（CEMIP）水平，采用放射免疫法检测血清CA19-9和CA242水平。应用受试者工作特征曲线（ROC）下面积（AUC）评价各指标的诊断效能。采用Kaplan-Meier和Cox风险比例模型行生存分析。采用Logistic回归分析影响术后生存的因素。结果 胰腺癌患者血清CEMIP、CA19-9和CA242水平分别为0.7（0.4，1.0） ng/mL、180.1（89.1，230.3） U/mL和61.7（20.7，93.5）U/mL，均显著高于胰腺良性疾病患者和健康人，差异有统计学意义（P均<0.05）；应用血清CEMIP、CA19-9和CA242联合诊断胰腺癌的AUC为0.966，其诊断效能显著高于任一指标单独诊断；应用血清CEMIP、CA19-9和CA242水平预测胰腺癌患者根治术后1年生存的效能均较高；经Kaplan-Meier和Cox多因素分析，结果表明肿瘤分化程度、血管侵犯、术后化疗、血清CEMIP≥0.7 ng/mL、CA19-9≥90.3 U/mL和CA242≥32.8 U/mL均是影响胰腺癌患者根治术后生存的独立危险因素。结论 检测胰腺癌患者血清CEMIP、CA19-9和CA242水平可有助于对疾病的诊断和预后评估。     

Serum levels of different tumour markers in patients with chronic heart failure

BACKGROUND: serum levels of carbohydratic antigen 125 (CA 125), a tumour marker related to ovarian cancer, are increased in patients with heart failure (CHF). To our knowledge there are no data concerning the levels of other tumour markers in CHF. METHODS: we measured serum levels of Alpha-Fetoprotein (AFP), Carcinoembrionic antigen (CEA), CA 19.9, CA 15.3 and CA 125, in 191 pts (86 males, mean age 67+/-10 years) with mild to severe CHF due to left ventricular systolic dysfunction. RESULTS: Only CA-125 was increased in CHF patients: mean values were significantly higher (P<0.05) in NYHA classes III (60+/-22 UI/ml) and IV (192+/-115 UI/ml) compared to NYHA class I-II patients (16+/-11). Mean values of the other tumor markers were within the normal range. AFP was above the upper normal limit in 2/191 patients (1%), CEA in 5/191 (2.6%), CA 19.9 in 0, CA 15.3 in 2/191 (1%) and CA 125 in 126/191 patients (66%). In 30 NYHA IV patients, tumour markers were repeated after 5-20 days of aggressive medical treatment, when a clinical improvement (reduction of at least 1 NYHA class) was reached: mean serum levels of CA 125 decreased from 107+/-85 to 19+/-8 U/ml (P<0.05); no changes in other tumour markers were observed. CONCLUSIONS: Of the tumour markers evaluated, only CA 125 seems to be related to the presence and severity of CHF and shows significant changes in response to medical therapy. The biologic and clinical relevance of this observation needs to be defined.     

联合CA19-9、CA125和CEA检测在AFP阴性的ICC鉴别诊断中的应用价值

目的探讨血清癌抗原19-9（CA19-9）、癌抗原125（CA125）和癌胚抗原（CEA）联合检测在甲胎蛋白（AFP）阴性的肝内胆管细胞癌（ICC）患者诊断中的价值。方法2014年6月~2016年6月我院收治的ICC患者60例,根据AFP检测结果,将其分为AFP阴性组和AFP阳性组,每组分别为30例。采用微阵列酶联免疫分析法（Array-ELISA）检测血清CA19-9、CA125和CEA,采用受试者工作特征曲线（ROC）下面积（AUC）分别对各标记物及联合检测诊断的灵敏度、特异度和正确率进行评估。结果30例AFP阴性组血清CA19-9、CA125和CEA水平分别为138.8（85.7~185.1）U/ml、109.6（48.4~201.8）U/ml、11.2（17.5~21.9）ng/ml,均显著高于AFP阳性组的【（38.0（16.9~75.5）U/ml、18.1（9.3~48.1）U/ml、5.5（3.1~8.5）ng/ml）,P<0.01】;两组血清肿瘤标志物诊断ICC的ROC曲线下面积均呈现出CA19-9>CA125>CEA的趋势,在AFP阴性组,各单项诊断的ROC曲线下面积分别为0.85、0.83和0.81,显著高于AFP阳性组的【（0.55、0.45和0.42）,P<0.05】;在单项诊断ICC时,血清CA19-9、CA125和CEA的最佳临床诊断截断点分别为124.89 U/ml、96.04 U/ml和11.97 ng/ml;血清CA19-9、CA125和CEA诊断ICC的灵敏度、特异度和正确率分别为（73.33%、76.67%和71.67%）、（66.67%、70.00%和68.33%）和（60.00%、70.00%和65.00%）,以CA19-9检测诊断的效能最高;两组联合检测诊断的ROC曲线下面积均高于单项指标检测的ROC曲线下面积,且都表现为（CA19-9/CA125/CEA）>（CA19-9/CA125）>（CA19-9/CEA）>（CA125/CEA）,在AFP阴性组,各联合检测诊断的ROC曲线下面积分别为0.94、0.88、0.86和0.85 ,显著高于在AFP阳性组的【（0.74、0.62、0.58和0.52）,P<0.05】;（CA19-9/CA125/CEA）、（CA19-9/CA125）、（CA19-9/CEA）和（CA125/CEA）四种联合检测诊断的灵敏度、特异度和正确率均提高,分别为（90.00%、90.00%和90.00%）、（83.33%、83.33%和81.67%）、（76.67%、83.33%和80.00%）和（70.00%、76.67%和73.33%）,以CA19-9/CA125/CEA联合检测诊断效能最高。结论我们认为,血清CA19-9、CA125和CEA联合检测可提高对AFP阴性ICC患者诊断的正确率,需要临床扩大验证。     

慢性充血性心力衰竭患者窦性心率震荡的检测和临床意义

目的探讨慢性充血性心力衰竭（CHF）患者窦性心率震荡的变化特点及其与心功能的关系,并进行预后判断。方法对100例（男61例,女39例;年龄45～86岁,平均62岁）慢性充血性心力衰竭患者和50例教师体检者进行24h动态心电图检查、心脏超声、常规12导联心电图,计算出心率震荡（HRT）的参数：震荡初始值（TO）及震荡斜率值（TS）,并分析两组的参数值,心脏超声测量左心室内径及射血分数。结果CHF组TO值（0.4839±0.1421）%,对照组TO值-（0.3467±0.1352）%;CHF组TS值（2.1638±0.2547）ms/RR间期,对照组TS值（6.2434±1.3589）ms/RR间期,两组比较,差异均有统计学意义。随访中发现TO、TS均异常的CHF患者的再住院率、死亡率均显著高于其他组。结论窦性心律震荡能反映压力感受器敏感性和自主神经平衡性的变化,对CHF患者的危重程度评价和预后判断有一定的参考意义。     

安体舒通在治疗67例慢性充血性心力衰竭中的作用

目的观察安体舒通在治疗慢性充血性心力衰竭（CHF）中的临床疗效。方法CHF病人132例,对照组65例,治疗组67例,对照组应用常规心力衰竭治疗,治疗组在常规心力衰竭治疗的基础上,加用安体舒通片20mg,1次／d,治疗4周,治疗前后评价左心功能,利用动态心电图监测心律失常情况。结果与对照组比较,治疗组心功能改善明显（P〈0．05）;治疗组室性心律失常发生率减少（P〈0．01）。结论安体舒通能够改善CHF患者心功能,减少室性心律失常发生。