循环内皮细胞对心力衰竭患者左室心功能及长期预后评价的临床价值  

Clinical value of circulating endothelial cells in heart failure patients for heart function evaluation and outcome prediction

作　　者：陈文生[1] 李广平[2] 杨立明[1] 孙淑娴[1] 赵庆霞[1] 张宇[1] 邸亚丽[1] 纪征[1] 

机构地区：[1]河北省唐山市唐山工人医院心内一科,063000 [2]河北省唐山市唐山工人医院检验科,063000

出　　处：《国际心血管病杂志》2015年第6期422-425,共4页International Journal of Cardiovascular Disease

摘　　要：目的：探讨循环内皮细胞（circulating endothelial cells，CECs）在心力衰竭（心衰）患者左心室功能及预后评价中的临床价值。方法：入选280例明确诊断为心衰的患者（病例组）和100例表观健康人（对照组），检测研究对象的CECs计数值，通过超声心动图记录左室舒张末期容积指数（LVEDVI）、左室收缩末期容积指数（LVESVI）、左室心肌质量指数（LVMI）及左室射血分数（LVEF）；分析CECs计数值和心功能参数的关联性；随访患者不良事件的发生情况，对不同CECs计数值分组的人群做生存分析。结果：病例组的CECs计数值显著高于对照组，为（9663±2395）／mL对（674±224）／mL，Pd0．01。CECs计数与LVEF呈负相关（r=-0．65），与LVEDVI（r=0．85）、LVESVI（r=0．68）、LVMI（r=0．63）呈正相关（P〈0．01）。病例组中CECs计数高于均数组的患者再入院及死亡发生率高于CECs计数低于均数组的患者，CECs≥9663／mL组患者的生存概率随时间的下降趋势大于CECs〈9663／mL组患者（HR=1．84，95％CI：1．26～2．67，P〈0．01）。结论：心衰患者CECs计数值明显升高，CECs计数值在评估心功能及不良事件发生风险方面具有参考价值。Objective： To explore clinical value of circulating endothelial ceils （CECs） for heart function evaluation and outcome prediction in heart failure （HF） patients. Methods： A total of 280 HF patients and 100 healthy people were enrolled and CECs were detected. Left ventricular end-diastolic volume index （LVEDVI）, left ventricular end-systolic volume index （LVESVI）, left ventrieular mass index （LVMI） and left ventricular ejection fraction （LVEF） were calculated by ultrasonic examination, and Pearson＇s r for CECs with heart function indexes was analized. The occurrence of adverse events was followed up, and the survival analysis of the different CECs subgroups was made. Results：Number of CECs in HF patients was significant higher than that in healthy people （9 663 ± 2 395/mL vs. 674 ± 224/mL, P〈0. 01 ）. CECs number was negatively correlated with LVEF（r = - 0. 65）, and positively correlated with LVEDVI （r= 0. 85）, LVESVI（r = 0. 68） and LVMI（r= 0. 63）, P〈0. 01. Re-admission and mortality rate in CECs≥9 663/mL subgroup were higher than those of CECs〈9 663/mL subgroup. The survival curves were significantly different between the two groups （HR = 1.84, P〈0. 01）. The decline trend of probability of survival in CECs≥9 663/mL subgroup was greater than that in CECs〈 9 663/mL subgroup. Conclusion： CECs count is higher in HF patients than healthy subjects. CECs index could provide clinical reference value for HF patients for heart function evaluation and long term prediction.

关 键 词：心力衰竭 循环内皮细胞 心功能 生存分析 

分 类 号：R541.6[医药卫生—心血管疾病]