慢性肾功能衰竭合并急性左心衰患者外周血清CA125水平与BNP水平及心功能的相关性

目的：探讨慢性肾功能衰竭合并急性左心衰患者外周血清癌抗原125(CA125)水平与B型脑钠肽(BNP)水平及心功能的相关性。方法选取2013年1月至2015年1月我院大内科收治的64例慢性肾功能衰竭合并急性左心衰患者作为观察组，根据心功能分级标准又分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级四个亚组，选取同期收治的30例慢性肾功能衰竭患者作为对照组。分别检测各组受检者的血清CA125和BNP水平，测量左室舒张末内径(LVEDD)和左射血分数(LEVF)，并分析患者外周血清CA125与BNP及心功能的关系。结果观察组患者的Ⅰ/Ⅱ级、Ⅲ级、Ⅳ级三个亚组的CA125、BNP水平分别为(24.76±5.68) U/mL、(81.55±22.59) U/mL、(168.74±34.79) U/mL；(508.74±63.84) pg/mL、(754.32±86.97) pg/mL、(912.54±112.43) pg/mL，均较对照组CA125(12.78±3.14) U/mL、BNP (362.23±49.13) pg/mL低，差异均有统计学意义(P<0.05)；观察组患者的Ⅰ/Ⅱ级、Ⅲ级、Ⅳ级三个亚组LEVF水平分别为(52.14±4.98)%、(44.16±5.27)%、(39.26±5.72)%，均明显低于对照组的(57.54±7.13)%，差异均有统计学意义(P<0.05)；观察组患者三个亚组的LVEDD水平与对照组比较差异均无统计学意义(P>0.05)；患者外周血清CA125和BNP水平随着心功能分级增加而升高，血清CA125和BNP水平均与心功能分级呈正相关(r1=3.452，r2=4.573，P<0.01)；血清CA125水平与BNP水平呈正相关(r=3.574，P<0.01)，与LEVF呈负相关(r=-3.258，P<0.01)，与LVEDD无显著相关性(r=1.183，P>0.05)。结论慢性肾功能衰竭合并急性左心衰患者外周血清CA125水平与BNP水平呈正相关，且CA125水平与急性左心衰严重程度密切相关，可作为慢性肾功能衰竭并发急性左心衰临床诊断和预后评估的重要指标。

Relationship between CA125 and BNP,heart function in patients with chronic renal failure and acute left heart failure

Objective To discuss the relationship between cancer antigen 125 (CA125) and B brain natriuretic peptide (BNP), heart function in patients with chronic renal failure and acute left heart failure. Methods Sixty-four pa-tients with chronic renal failure and acute left heart failure from January 2013 to January 2015 in our hospital were taken as study group. According to heart function grade of NYHA, the patients were divided intoⅠ,Ⅱ,ⅢandⅣsubgroups. Thirty patients with chronic renal failure were selected and taken as control group. The levels of CA125 and BNP were de-tected, and the left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LEVF) were mea-sured. The relationships between CA125 and BNP, heart function in patients with chronic renal failure and acute left heart failure were analyzed. Results The CA125 and BNP levels inⅠ/Ⅱ,Ⅲ,Ⅳsubgroups of the study group were (24.76 ± 5.68) U/mL, (81.55 ± 22.59) U/mL, (168.74 ± 34.79) U/mL and (508.74 ± 63.84) pg/mL, (754.32 ± 86.97) pg/mL, (912.54 ± 112.43) pg/mL, which were significantly lower than those in the control group of (12.78 ± 3.14) U/mL and (362.23 ± 49.13) pg/mL, with statistically significant differences (P<0.05). The LEVF levels were (52.14 ± 4.98)%, (44.16±5.27)%, (39.26±5.72)%inⅠ/Ⅱ,Ⅲ,Ⅳsubgroups of the study group, which were significantly lower than that in the control group of (57.54±7.13)%, and the differences were statistically significant (P<0.05). The LVEDD levels inⅠ/Ⅱ,Ⅲ,Ⅳsubgroups of the study group showed no significant difference with the level in the control group (P>0.05). The levels of CA125 and BNP had risen with the increasing of heart function grade of NYHA, and CA125, BNP and heart function grade of NYHA were positively correlated (r1=3.452, r2=4.573, P<0.01). The levels of CA125 and BNP were posi-tively correlated (r=3.574, P<0.01), while the levels of CA125 and LEVF were negatively correlated (r=-3.258, P<0.01). The levels of CA125 and LVEDD had no correlation (r=1.183, P>0.05). Conclusion The levels of CA125 and BNP are positive-ly correlated in patients with chronic renal failure and acute left heart failure. The levels of CA125 are closely related to sever-ity of acute left heart failure, which can apply to clinical diagnosis and prognosis evaluation in patients with chronic renal failure combined with acute left heart failure.