血清糖类抗原125对慢性心衰患者病情评估、疗效判定及预后预测价值的研究

目的探讨血清糖类抗原125（CA-125）对慢性心衰患者病情评估、疗效判定及预后预测的价值。方法连续选取慢性心衰患者120例（心衰组）,同时选取同期住院非心衰患者120例作为对照组,测定CA125、N端B型脑钠肽前体（NT-proBNP）水平及超声心动图指标,比较两组患者之间的差异;心衰组患者给予抗心衰治疗2周后复测CA125、NTproBNP水平,按照治疗效果分为显效组、有效组和无效组,分别比较治疗前后CA125水平的差异;心衰组按照CA125平均水平分为高水平组和低水平组,随访1年,比较两组患者再住院率和死亡率。结果心衰组CA125及NT-proBNP水平均明显高于对照组（P=0.000）,根据左室射血分数分组后,左心室射血保留心衰组（HFPEF组）和左心室射血分数下降心衰组（HFREF组）CA125及NT-proBNP水平均明显高于对照组（P值均为0.000）;心衰组按NYHA心功能分级,心功能越差CA125及NT-proBNP水平越高,差异有统计学意义（P〈0.05）;慢性心衰患者CA125水平与NT-proBNP水平呈正相关（r=0.72,P=0.006）,与LVEF呈负相关（r=-0.69,P=0.009）;心衰组抗心衰治疗2周,显效组和有效组治疗前后CA125及NTproBNP水平比较差异有统计学意义（P值均为0.000）,而无效组差异无统计学意义（P=0.104）;高CA125水平组1年再入院率、死亡率分别为34.04%和17.02%,明显高于低CA125水平组的14.50%和5.80%（P值为0.000和0.002）。结论 CA125水平不仅可以作为慢性充血性心力衰竭诊断的一项重要指标,还可以反映心衰程度及治疗效果,同时对预后判断具有参考价值。

Studies on the value of CA125 in the assessment,treatment and prognosis of patients with chronic heart failure

Objective To discuss the value of CA125 in the assessment,treatment and prognosis of patients with chronic heart failure. Methods Chose 120 patients with chronic heart failure and 120 patients without chronic heart failure disease. CA125, NT-proBNP and echocardiography were assayed respectively;then patients with CHF were divided into three groups（markedly effective group, effective group and ineffective group） according to different therapeutic efficacy after two weeks standard heart failure therapy,then compared CA125 and NT-proBNP degree between pretherapy and post-treatment in the three different groups. Observed the difference of rehospitalization and mortality among patients with high level and low level of CA125 degree in one year follow-up visit. Results The degree of CA125 and the level of NT-proBNP in patients with CHF was remarkablely higher than the group without CHF, the cases was grouped according to the ejection fraction of ventriculus sinister, the degree of CA125 and the level of NF-proNBNP of HTPEF group and HFREF group were obviously higher than the control group. The Heart failure group was graded by NYHA,the worse that the cardiac function was,the higher level of CA125 and NFpro BNP were. In group with CHF, CA125 level was positively correlated with NT-proBNP（r=0.72,P〈0.05） and negatively correlated with LVEF（r=-0.69,P〈0.05）. After two weeks standard heart failure therapy,the level of CA125 and NT-proBNP of excellent group（P〈0.05） and effective group decreased remarkablely than pretherapy,but unchanged in ineffective group（P〈0.05）. In one year follow-up visit,the rehospitalization and mortality in group with high CA125 level（34.04% and 17.02%） were higher than that in group with low CA125 level（14.50% and 5.80%）, there were statistically significant differences between the two groups（P〈0.05）. Conclusion The level of CA125 is valuable in the assessment, treatment and prognosis of patients with chronic heart failure.