半乳糖凝集素-3在慢性心肾综合征中的诊断及其对预后判断的价值

目的 探讨血浆半乳糖凝集素-3(Gal-3)水平在慢性心肾综合征(CRS)患者中的诊断及其对预后判断的价值。方法 选取2013年8月至2014年1月池州市人民医院心血管内科因慢性心力衰竭而住院的患者104例,记录入选者一般临床资料,将纽约心功能分级(NYHA)Ⅲ~Ⅳ级并且肾小球滤过率(c-aGFR)<60 mL·min^-1·1.73 m^-2分为CRS组(21例)和非CRS组(83例),均空腹检测血浆Gal-3、血清氨基末端脑钠肽前体(NT-proBNP)、血清肌酐(Scr)以及血红蛋白(HGB)等水平,随访出院后3个月的再住院以及心血管终点事件的发生情况。结果 CRS组lgGal-3水平为(2.17±0.42)ng/L,非CRS组lgGal-3水平(1.58±0.39)ng/L,两组差异有统计学意义(P<0.05)。lgGal-3与lgNT-proBNP(r=0.520,P<0.05)、lgScr(r=0.506,P<0.05)均呈正相关。多因素logistic回归分析显示,Gal-3为慢性CRS的独立危险因素(P<0.05)。CRS组随访3个月的再住院以及心血管终点事件发生率均明显高于非CRS组,差异有统计学意义(P<0.05)。根据ROC曲线,Gal-3诊断慢性CRS的曲线下面积为0.842,最佳的界值为79.84 ng/L,敏感性为81.0%,特异性为80.7%。结论 血浆Gal-3在慢性CRS中具有一定的诊断价值,并可用于预测慢性CRS患者的短期预后。

Value of galectin-3 for diagnosis and prognosis in patients with chronic cardiorenal syndrome

Objective To evaluate the diagnostic value and its influence on prognosis of the plasma galectin-3 (Gal-3) levels in patients with chronic cardiorenal syndrome (CRS). Methods According to the New York Heart Association (NYHA) functional class III-IV level and Chinese glomerular filtration rate (c-aGFR) <60 mL·min^-1·1.73m^-2, 104 patients with chronic heart failure admitted in our hospital from August 2013 to January 2014 were divided into two group. They were 21 patients with cardiorenal syndrome (CRS group) and 83 patients with non-cardiorenal syndrome (non-CRS group). General clinical data of all patients were collected and recorded. All patients were fasting detected by the level of plasma Gal-3, serum N-terminal pro brain natriuretic peptide (NT-proBNP), serum creatinine (Scr) and hemoglobin (HGB) and so on. All patients were followed up for 3 months to observe the incidence of hospitalization and cardiovascular endpoint events. Results The values of lgGal-3 in CRS group and non-CRS group were (2.17±0.42)ng/L and (1.58±0.39)ng/L, respectively. The levels of lgGal-3 were positively correlated to the values of lgNT-proBNP (r=0.520, P<0.05), lgScr (r=0.506, P<0.05). Multivariate analysis showed that Gal-3 was the independent risk factor of CRS (P<0.05). The incidence of hospitalization and cardiovascular endpoint events in CRS-group was significantly higher than that in non-CRS group during the 3 months of follow-up, and the difference between the two groups was statistically significant(P<0.05). Taking Gal-3 level 79.84 ng/L as the cut-off value, for predicting the CRS by the area under ROC curve was 0.842, with the sensitivity of 81.0% and the specificity of 80.7%. Conclusion The plasma Gal-3 can be used as a diagnostic indicator of chronic cardiorenal syndrome, and can be used to predict short term re-hospitalization rate and cardiovascular endpoints.