急性心力衰竭患者血清半乳凝素-3的变化及临床意义  

Alterations and clinical value of serum galectin-3 in patients with acute heart failure

作　　者：顾薇[1,2] 李艳艳 吴立群[1] 邵金炎[2] 周玲 邓星奇[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院心内科,上海200025 [2]上海瑞金医院集团闵行区中心医院急诊科,上海201199

出　　处：《内科理论与实践》2014年第3期174-178,共5页Journal of Internal Medicine Concepts & Practice

摘　　要：目的：通过检测急性心力衰竭（心衰）患者血清半乳凝素-3（galectin-3，Gal-3）的变化，探讨Gal-3在心衰发病中的作用。方法：选择急性心衰患者120例，其中纽约心脏病协会fNYHA）心功能Ⅱ级30例，Ⅲ级50例，Ⅳ级40例。于治疗前、后检测Gal-3和氨基末端脑钠肽前体（NT-proBNP），超声心动图测左心房内径（LAD）、左心室舒张末期内径（LVEDD）和左心室射血分数（LVEF）。并以健康体检者40名为对照组。结果：NYHAⅡ～Ⅳ级组血Gal-3、NT-pmBNP水平高于对照组（P〈0．05）；各亚组之间Gal-3、NT-proBNP水平均有差异（均P〈0．05）。LVEF≤40％组治疗前血Gal-3、NT-pmBNP水平高于LVEF〉40％组fP〈0．05）；LVEDD〉70mm组Gal-3水平高于LVEDD〈50mm组及LVEDD50～70mm组（P〈0．05），而LVEDD50～70mm组Gal-3水平高于LVEDD〈50mm组（P〈0．05）；NT-proBNP在治疗前、后均无差异。治疗前Gal-3、NT-proBNP水平分别与NYHA分级、LAD、LVEDD呈正相关、与LVEF呈负相关（r分别为0．64、0．48、0．67、-0．67，P〈0．05或P〈0．01）；治疗前Gal-3与NT-proBNP呈正相关（r=0．41，P〈0．05）。发生心脏不良事件者Gal-3、NT-proBNP水平更高。结论：急性心衰患者血Gal-3水平与心衰严重程度相关，与左心室的结构和功能相关，提示Gal-3可能参与急性心衰的发病过程。Gal-3和NT-pmBNP水平同时异常升高者近期预后差。Objective To investigate the alterations and clinical value of serum galectin-3 （Gal-3） in patients with acute heart failure （AHF）. Methods One hundred and twenty patients with AHF were recruited： New York Heart Association （NYHA） Ⅱ 30 patients, NYHA Ⅲ 50 patients, NYHA Ⅳ 40 patients. Levels of serum Gal-3 and N-terminal pro-brain natriuretic peptide （NT-proBNP） were measured before and after treatment. Echocardiography was performed to measure left atrial diameter （LAD）, left ventricular end-diastolic diameter （LYEDD） and left ventricular ejection fraction （LVEF）. Forty healthy peoples were selected as control group. Results Levels of serum Gal-3 and NT-proBNP were significantly higher in NYHA Ⅱ -Ⅳ groups than that in controls （P〈0.05）. Levels of serum Gal-3 and NT-proBNP showed significant difference between the three NYHA subgroups. Before treatment, levels of Gal-3 and NT-proBNP were significantly higher in patients with LVEF ≤40% than those in patients with LVEF〉40% （P〈0.05）. Level of Gal-3 was higher in patients with LVEDD more than 70 mm than that in patients with LVEDD ranged from 50 mm to 70 mm. And the level of Gal-3 in patients with LVEDD 50-70 mm was higher than that in patients with LVEDD less than 50 mm （P〈 0.05）. Before treatment, levels of serum Gal-3 and NT-proBNP were positively correlated with NYHA class , LAD and LVEDD, and negatively correlated with LVEF. Level of serum Gal-3 before treatment was positively correlated with level of NT-proBNP. Patients who had higher levels of Gal-3 and NT-proBNP were prone to have cardiac adverse events. Conclusions Level of serum Gal-3 is correlated with severity of AHF, structure and function of left ventricle in patients with AHF, indicating that Gal-3 may be involved in the process of AHF. Patients with higher levels of both Gal-3 and NT- proBNP have poor prognosis.

关 键 词：半乳凝素-3 氮基末端脑钠肽前体 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]