血管生长素与超声心动图对冠心病心衰患者诊断的一致性研究  

The Analysis of Consistency between Angiogenin and Echocardiography in the Diagnosis of Coronary Heart Disease with Heart Failure

作　　者：于鹏[1] 虞莹[1] 赵吉[1] 周年伟 刘明[1] 张磊[1] 姜红[1] 邹云增[1] 葛均波[1] 

机构地区：[1]复旦大学附属中山医院上海心血管疾病研究所,上海市200032 [2]上海市影像医学研究所 复旦大学附属中山医院心超室,上海市200032

出　　处：《中国分子心脏病学杂志》2014年第6期1114-1116,共3页Molecular Cardiology of China

基　　金：国家自然科学基金(81170221);教育部博士点课题基金(20130071110040)

摘　　要：目的探索冠心病患者进展为心力衰竭过程中,血浆血管生长素（ANG）水平与超声心动图表现的变化情况,以及二者对冠心病合并心衰的诊断效能。方法选取2013年10月到2014年10月在复旦大学附属中山医院诊断为冠心病患者56例,其中25例合并慢性心力衰竭,其余31例为非心衰患者。对其进行血浆ANG浓度测定。并对这些患者心超报告进行分析,计算根据美国心脏超声协会即推荐16节段左心室室壁运动指数（LVWMI）积分。分析二者的相关性,并用受试者工作特征曲线（ROC）曲线评价二者对心衰诊断的作用。结果单纯冠心病组与冠心病合并心衰组相比,N末端B型利钠肽（NT-pro BNP）、ANG、LVWMI具有显著差异,两组ANG分别为（2905.0±741.6）pg/ml与（3977.6±963.2）pg/ml,LVWMI积分分别为1.989±0.383与1.361±0.274,二者与NT-pro BNP均具有显著相关性（P〈0.01,Pearson相关检验）。ANG与LVWMI对冠心病慢性心衰诊断的ROC曲线下面积分别为0.7935（95%可信区间0.66780~0.91930）、0.9168（95%可信区间0.84835~0.98520）,二者合并后对冠心病心衰诊断的ROC曲线下面积为0.9200（0.84890~0.99110）。结论冠心病合并心衰患者血浆ANG水平较未合并心衰组显著升高,左心室节段收缩功能显著下降,二者是诊断冠心病合并心衰的良好指标。Objective To study the plasma angiogenin（ANG） and echocardiogram change in the process of progression from coronary heart disease（CHD） to heart failure（HF） and confirm their efficacy in the diagnosis of CHD with HF. Methods We recruited 56 CAD patients in this study among whom 25 diagnosed as CHF from October 2013 to October 2014 hospitalized in Zhongshan Hospital Fudan University. They were subjected to plasma ANG determination. And a 16-segment left ventricular wall motion index（LVWMI） based on the American Society of Echocardiography model was used to assess the patients’ cardiac function according to their echo report. We calculated the relationship between ANG and LVWMI. volunteers. ROC was used to evaluate the roles of ANG and LVWMI in the diagnosis of HF. Results Compared with the CHD patients group, NT-pro BNP, LVWMI and ANG significantly elevated in the CHD with HF patients group, and ANG and LVWMI correlated with NT-pro BNP significantly（P 〈 0.01, Pearson correlation test）. ANG and LVWMI showed AUCs of 0.7935（95% CI 0.66780~0.91930） and 0.9168（95% CI 0.84835~0.98520） for diagnosis of HF from CHD cohort. Conclusion ANG is upregulated significantly and the segment systolic function of left ventricle in CHD with HF patients compared with the CHD patients without HF. ANG and LVWMI may be used as a indicator to diagnose HF in the CHD cohort.

关 键 词：冠心病 心力衰竭 血管生长素 诊断 

分 类 号：R541.6[医药卫生—心血管疾病]