冠心病患者血清CA125与心功能及细胞因子的相关性

目的:研究冠心病患者血清CA125水平与心功能及细胞因子的相关性。方法:选择136例冠心病患者(CHD组),根据症状分为稳定型心绞痛(SAP)组(82例)和不稳定型心绞痛(UAP)组(54例),根据血管狭窄数目分为单支病变组(41例)、双支病变组(46例)和多支病变组(49例),按NYHA心功能分级标准分为Ⅰ级(31例)、Ⅱ级(44例)、Ⅲ级(37例)、Ⅳ级(24例)组。另选择69例健康人作为健康对照组。比较不同组的血清CA125、BNP、hsCRP、同型半胱氨酸(Hcy)、LVEF水平及分析血清CA125与心功能及细胞因子的相关性。结果:与健康对照组比较,CHD组血清CA125、BNP、hsCRP、Hcy水平明显升高,LVEF明显下降(P<0.05或<0.01),且UAP组CA125、BNP、hsCRP较SAP组明显升高,LVEF明显下降(P<0.05或<0.01);单支、双支、多支病变组3组血清CA125、BNP、hsCRP水平逐渐升高,LVEF逐渐下降,差异均有显著性(F=5.12、6.31、7.83、5.64,P<0.05);NYHAⅠ级、Ⅱ级、Ⅲ级、Ⅳ级组血清CA125、BNP、hsCRP水平逐渐升高、LVEF逐渐下降,差异均有显著性(F=5.39、6.23、6.74、5.14,P<0.05);血清CA125水平与冠脉病变积分、病变支数,心功能级别,BNP,hsCRP呈正相关(r=0.41、0.45、0.52、0.56、0.49,P<0.05),与LVEF呈负相关(r=-0.47,P<0.05)。结论:CA125的过度分泌通过与hsCRP、BNP的相互作用可加重冠心病患者病情,恶化其心功能。

Correlation among cardiac function, cytokines and serum CA125 in patients with coronary heart disease

Objective： To study correlation among cardiac function, cytokines and serum CA125 level in patients with coronary heart disease （CHD）. Methods： According to symptoms, a total of 136 CHD patients （CHD group） were divided into stable angina pectoris （SAP） group （n = 82） and unstable angina pectoris （UAP） group （n = 54） ; ac- cording to number of stenotic vessels, CHD patients were divided into single vessel coronary disease （SVD） group （n = 41）, double vessel coronary disease （DVD） group （n = 46） and multiple vessel coronary disease （MVD） group （n = 49） ; according to NYHA cardiac function, CHD patients were divided into NYHA class I group （n = 31）, class lI group （n = 44）, class Ill group （n = 37） and class 1V group （n = 24）. Another 69 healthy subjects were enrolled as healthy control group. Levels of serum CA125, BNP, hsCRP, homocysteine （Hcy） and LVEF were compared a- mong these groups, and correlation among cardiac function, cytokines and serum CA125 was analyzed. Results： Compared with healthy control group, there were significant increase in levels of serum CA125, BNP, hsCRP and Hcy, and significant decrease in LVEF in CHD group （P〈0.05 or 〈0.01） ; compared with SAP group, there were significant increase in levels of CA125, BNP and hsCRP, and significant decrease in LVEF in UAP group （P〈0.05 or 〈0.01） ; levels of serum CA125, BNP and hsCRP gradually increased and LVEF gradually decreased from SVD group, DVD group to MVD group in order （F = 5.12, 6.31, 7.83, 5.64, P〈0.05）; levels of serum CA125, BNP and hsCRP gradually increased and LVEF gradually decreased from NYHA class I group, class II group, class Ill group to class IV group in order （F= 5.39, 6.23, 6.74, 5.14, P〈0.05） ; Serum CA125 level was positively correla- ted with pathological score, number of coronary disease vessels, NYHA class, levels of BNP and hsCRP （r = 0.41, 0.45, 0.52, 0.56, 0.49, P〈0.05）, and negatively correlated with LVEF （r = - 0.47, P〈0.05）. Conclusion： Ex-cessive secretion of CA125 could aggravate patient＇s condition and cardiac function through interaction with hsCRP and BNP.