慢性心力衰竭患者血清半乳糖凝集素-3和心型脂肪酸结合蛋白表达水平及其诊断和预后价值

摘要

目的探讨血清半乳糖凝集素-3、心型脂肪酸结合蛋白(heart fatty acid binding protein,h-FABP)表达水平及其在慢性心力衰竭(chronic heart failure,CHF)患者诊断和预后中的价值.方法将2015年10月至2016年10月本院心内科收治的96例CHF患者纳入CHF组.另将同期本院40例健康体检者纳入对照组,采用酶联免疫吸附测定检测两组研究对象血清半乳糖凝集素-3和h-FABP水平,应用彩色多普勒超声仪测定两组研究对象左室射血分数(left ventricular ejection fraction,LVEF)、二尖瓣舒张早期充盈峰(E峰)、左室重量指数(left ventricular mass index,LVMI)、左室舒张末期内径(left ventricular end-diastolic diamete,LVEDd).采用Pearson单因素分析探讨血清galectin-3和H-FABP水平与心功能的关系.应用接受者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析血清半乳糖凝集素-3和h-FABP在心力衰竭中的应用价值.结果CHF组患者血清半乳糖凝集素-3和h-FABP表达水平、LVEF、E峰、LVMI及LVEDd均高于对照组(P<0.05),且随着心功能分级的增加,血清半乳糖凝集素-3和h-FABP水平均显著升高(P<0.05).死亡组患者血清半乳糖凝集素-3和h-FABP表达水平均显著高于存活组(P<0.01).Pearson单因素分析显示,血清半乳糖凝集素-3和h-FABP表达水平与LVEF均呈负相关(P<0.01),与E峰、LVMI、LVEDd均无明显相关性(P>0.05).ROC曲线分析显示,血清半乳糖凝集素-3联合h-FABP检测对CHF死亡率诊断的灵敏度和特异度均显著高于单一指标(P<0.05).结论血清半乳糖凝集素-3和h-FABP表达水平升高与CHF病情进展密切相关,可作为评价CHF预后的指标.%Objective To explore the expression level of serum galectin-3 and heart fatty acid binding protein (h-FABP) in patients with chronic heart failure (CHF) and its diagnostic and prognostic value. Method 96 cases of CHF patients from October 2015 to October 2016 admitted in our hospital were selected as the research objects. 40 cases of healthy physical examinationers were included in control group during the same period, used enzyme-linked immunosorbent assay to detected the serum levels of galectin-3 and h-FABP of both groups, the left ventricular ejection fraction (LVEF), left ventricular ejection fraction (LVEF), mitral peak early diastolic filling (E peak), left ventricular weight index (LVMI), left ventricular end-diastolic diameter (LVEDd) were determined by using color Doppler ultrasound instrument of both groups. The relationship between serum galectin-3 and h-FABP levels and cardiac function were investigated by Pearson single factor analysis. Receiver operating characteristic curve (ROC curve) were used to analyze the application value of serum galectin-3 and h-FABP in heart failure. Result The levels of serum galectin-3 and h-FABP, LVEF, E peak, LVMI and LVEDd in CHF group were higher than those in control group (P<0.05). With the increase of cardiac function classification, the levels of serum galectin-3 and h-FABP were significantly increased (P<0.05). The serum levels of galectin-3 and h-FABP in death group were significantly higher than those in survival group (P<0.01).Pearson single factor analysis showed that the levels of serum galectin-3 and h-FABP were negatively correlated with LVEF (P<0.01), and there was no significant correlation between and E, LVMI and LVEDd (P>0.05). ROC curve analysis showed that the sensitivity and specificity of galectin-3 combined with h-FABP in the diagnosis of CHF mortality were significantly higher than that of a single index (P<0.05). Conclusion The elevated levels of serum galectin-3 and h-FABP are closely related to the progression of CHF and can be used as an index for the prognosis of CHF.