慢性心力衰竭患儿血清半乳糖凝集素-3变化及临床意义

目的探讨慢性心力衰竭(CHF)患儿血清半乳糖凝集素-3(galectin-3)变化及其与左心室重构的相关性。方法选取CHF患儿45例,按心衰严重程度分为心功能Ⅱ级组、Ⅲ级组和Ⅳ级组;按原发疾病分为心内膜弹力纤维增生症(EFE)组和扩张型心肌病(DCM)组;30例健康体检儿童为对照组。采用酶联免疫吸附法(ELISA)测定血清galectin-3水平,放射免疫分析法测定NT-pro BNP,超声心动图测定左心室重构指标。分析血清galectin-3与左心室重构和NT-pro BNP的相关性。结果 45例CHF患儿中,男19例、女26例,年龄(3.42±1.89)岁。心功能Ⅱ级组10例,Ⅲ级组18例和Ⅳ级组17例;EFE组21例,DCM组24例。心功能Ⅱ级、Ⅲ级、Ⅳ级组患儿的血清galectin-3及NT-pro BNP水平均高于对照组,差异有统计学意义(P均0.05),不同心功能分级组两两比较差异均有统计学意义(P?0.05)。EFE和DCM两组间血清galectin-3水平差异无统计学意义(P?0.05)。Spearman秩相关分析结果显示,CHF患儿的血清galectin-3水平与左心室舒张末径、左心质量、左心质量分数及血清NT-pro BNP水平呈正相关(P均0.05),与左室射血分数、左室短轴缩短率均呈负相关(P均0.05)。结论血清galectin-3有助于对儿童CHF的临床诊断和病情评估。

Variation and clinical signiifcance of serum galectin-3 in children with chronic heart failure

Objective To explore the variation of serum galectin-3 and its correlation with ventricular remodeling in children with chronic cardiac failure (CHF). Methods Forty-ifve children with CHF were included and divided into cardiac function II group (n=10 ), III group (n=18 ), and IV group (n=17 ) according to the severity of CHF. The subjects were also divided into endocardial fibroelastosis (EFE) group (n=21 ) and dilated cardiomyopathy (DCM) group (n=24 ) according to primary disease. Thirty health children were included as control group. The level of serum galectin-3 was detected by ELISA. The level of serum NT-pro BNP was measured by radio immunoassay. The index of ventricular remodeling was detected by ultrasonic cardiogram. The correlation of the level of serum galectin-3 with ventricular remodeling and the level of serum NT-pro BNP were analyzed. Results In 45 children ( 19 males and 26 females) with CHF, the mean age was 3 . 42 ± 1 . 89 years. The levels of serum galectin-3 and NT-pro BNP were higher in cardiac function II group, III group, and IV group than those in control group (all P?0 . 05 ). Spearman rank correlation analysis showed that the level of serum galectin-3 was positively correlated with the left ventricular end diastolic diameter, the left ventricular mass, the left ventricular mass fraction, and the level of serum NT-pro BNP (all P?