血浆半乳糖凝集素3水平与老年慢性心力衰竭患者微量白蛋白尿的关系研究  

Relationship between Plasma Galectin-3 Level and Microalbuminuria in Elderly Patients with Chronic Heart Failure

作　　者：李绍华[1] 黄鸿辉 张永佳 LI Shao-hua;HUANG Hong-hui;ZHANG Yong-jia(Department of Cardiovascular Medicine,Puning Overseas Chinese Hospital,Puning 515300,China)

机构地区：[1]普宁华侨医院心血管内科,广东省普宁市515300

出　　处：《实用心脑肺血管病杂志》2018年第7期14-17,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：揭阳市科技计划项目(2017YL029)

摘　　要：目的探讨血浆半乳糖凝集素3(Gal-3)水平与老年慢性心力衰竭(CHF)患者微量白蛋白尿(MAU)的关系。方法选取2014年8月—2017年1月普宁华侨医院收治的老年CHF患者143例,根据有无MAU分为非MAU组89例和MAU组54例。比较两组患者临床资料,老年CHF患者MAU影响因素分析采用多因素Logistic回归分析,并绘制ROC曲线以评价血浆Gal-3水平对老年CHF患者MAU的预测价值。结果两组患者年龄、男性比例、缺血性心肌病发生率、高血压发生率、体质指数、收缩压、使用血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)者所占比例、使用β-受体阻滞剂者所占比例、使用利尿剂者所占比例、使用醛固酮受体拮抗剂者所占比例、左心室舒张末期容积(LVEDV)及左心室射血分数(LVEF)比较,差异无统计学意义(P>0.05);两组患者糖尿病发生率、纽约心脏病协会(NYHA)分级、估算肾小球滤过率(e GFR)及血浆N末端脑钠肽前体(NT-pro BNP)、Gal-3水平比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血浆Gal-3水平是老年CHF患者MAU的独立影响因素[OR=1.75,95%CI(1.07,2.86),P<0.05]。ROC曲线显示,血浆Gal-3水平预测老年CHF患者MAU的曲线下面积(AUC)为0.724,最佳截断值为13.1μg/L,灵敏度为49.3%,特异度为92.3%。结论血浆Gal-3水平是老年CHF患者MAU的独立影响因素,且其对老年CHF患者MAU的发生具有一定预测价值。Objective To investigate the relationship between plasma galectin-3(Gal-3)level and microalbuminuria(MAU)in elderly patients with chronic heart failure(CHF).Methods A total of 143 elderly patients with CHF were selected in Puning Overseas Chinese Hospital from August 2014 to January 2017,and they were divided into non-MAU group(without MAU,n=89)and MAU group(with MAU,n=54)according to the incidence of MAU.Clinical data was compared between the two groups,influencing factors of MAU in elderly patients with CHF were analyzed by multivariate Logistic regression analysis,and ROC curve was drawn to evaluate the predictive value of plasma Gal-3 level on MAU in elderly patients with CHF.Results No statistically significant differences of age,male proportion,incidence of ischemic cardiomyopathy or hypertension,BMI,SBP,proportion of patients using ACEI/ARB,β-acceptor blockers,diuretic or aldosterone receptor antagonist,LVEDV or LVEF was found between the two groups(P>0.05);while there were statistically significant differences of incidence of diabetes,NYHA grade,eGFR,plasma levels of NT-proBNP and Gal-3(P<0.05).Multivariate Logistic regression analysis results showed that,plasma Gal-3 level was one of independent influencing factors of MAU in elderly patients with CHF〔OR=1.75,95%CI(1.07,2.86),P<0.05〕.ROC curve showed that,the AUC of plasma Gal-3 level in predicting MAU in elderly patients with CHF was 0.724,the optimum truncation value was 13.1μg/L,the sensitivity was 49.3%,the specificity was 92.3%.Conclusion Plasma Gal-3 level is one of independent influencing factors of MAU in elderly patients with CHF,has certain predictive value on MAU.

关 键 词：心力衰竭 老年人 半乳糖凝集素3 微量白蛋白尿 

分 类 号：R541.6[医药卫生—心血管疾病]