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。

A Study of Relation Between CA125 Level and Congestive Heart Failure

Objectives: To study the relation between the serum level of CA125 and congestive heart failure. Method: One hundred and eight patients were divided into three groups based on standard New York Heart Association classification. The patients were subdivided into PF (pleural fluid) group and non-PF group based on the presence of fluid in pleural cavity, Fouty patients with cardiovascular disease but without heart failure were recruited as control group. The level of CA125 was detected by ELISA method, and ejection fraction(EF) and pleural fluid were detected by ultrasound. Results: The level of CA125 in the patients with heart failure and pleural fluid was much higher than that without heart failure or pleural fluid, and there was obvious relevance between CA125 level and EF. The levels showed no difference between patients with valve disease, dilated cardiomyopathy,cornary heart disease or hypertensive heart diasese. Conclusion: (1)The level of CA125 in patients with heart failure was higher than that without heart failure and it was negatively correlated with the level of EF. It was not influenced by the reasons causing heart failure. (2)The level of CA125 in the PF group was higher than that of non-PF group. This may be associated with the increased secretion of pleural mesothelium of the decreased clearance of CA125. (3)The measurements of CA125 may be used to evaluate the therapeutic effect for heart failure and short-term or long-term prognosis.