心肌梗死后缺血性心肌病心衰患者血浆半乳糖凝集素3的表达及其临床意义  

Expression of Plasma Galectin-3 in Patients with Ischemic Cardiomyopathy and Heart Failure After Myocardial Infarction and Its Clinical Significance

作　　者：朱贝利 刘辉[1] 耿硕章 郭军霞[1] 张永春[1] ZHU Bei-li;LIU Hui;GENG Shuo-zhang;GUO Jun-xia;ZHANG Yong-chun(Department of Cardiology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,Henan,China)

机构地区：[1]新乡医学院第一附属医院心内科,河南新乡453100

出　　处：《医学信息》2020年第15期61-64,共4页Journal of Medical Information

基　　金：河南省科技攻关计划项目(编号:152102310114);河南省医学科技攻关计划普通项目(编号:201602155)。

摘　　要：目的研究心肌梗死后缺血性心肌病(ICM)心力衰竭(心衰)患者血浆中半乳糖凝集素3(Gal-3)的表达水平变化,并探讨其临床意义。方法选取2018年7月~2019年2月在我院收治的29例心肌梗死后ICM心衰患者设为心梗后ICM心衰组,27例非心肌梗死后ICM心衰患者设为非心梗后ICM心衰组,21例非ICM心衰患者设为非ICM心衰组,22例正常对照患者设为正常对照组。采用酶联免疫吸附测定法检测四组患者血浆中Gal-3及氨基末端脑钠肽前体(Nt-proBNP)的表达水平,并用超声心动图检查其左房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)。比较四组一般资料、血浆Gal-3水平,分析Gal-3水平对心力衰竭及心梗后ICM心衰诊断的敏感度与特异性、四组Gal-3水平与心功能的相关性。结果四组患者Gal-3水平比较,差异有统计学意义(P<0.05),其中心梗后ICM心衰组Gal-3水平最高。心梗后ICM心衰组Gal-3水平均高于非心梗后ICM心衰组、非ICM心衰组、正常对照组(P<0.05);非心梗后ICM心衰组、非ICM心衰组Gal-3水平均高于正常对照组(P<0.05);非心梗后ICM心衰组和非ICM心衰组Gal-3水平比较,差异无统计学意义(P>0.05);Gal-3对心力衰竭诊断的ROC AUC为0.989,具有较好的诊断效能。Gal-3对心梗后ICM心衰诊断的ROC AOC为0.753,具有一定的诊断效能。四组LVEDD、LVEF比较,差异有统计学意义(P<0.05),心梗后ICM心衰组LVEDD最高,LVEF最低。Spearman相关性分析显示,心梗后ICM心衰组Gal-3水平与LVEDD成正相关(r=0.407,P<0.05),LVEF成负相关(r=-0.620,P<0.05),与LAD无相关性(P>0.05);非心梗后ICM心衰组、非ICM心衰组、正常对照组Gal-3水平与其LAD、LVEDD、LVEF均无相关性(P>0.05)。结论心肌梗死后缺血性心肌病心衰患者血浆中Gal-3表达水平升高,并且与患者左室结构和功能变化存在相关性,在临床上对此类患者病情及预后评估具有重要作用。Objective To study the changes of galectin-3(Gal-3)expression in plasma of patients with ischemic cardiomyopathy(ICM)and heart failure(heart failure)after myocardial infarction,and to explore its clinical significance.Methods 29 patients with ICM heart failure after myocardial infarction who were admitted to our hospital from July 2018 to February 2019 were selected as the post-MI heart failure group,and 27 patients with non-myocardial infarction ICM heart failure were set as non-MI In the post-ICM heart failure group,21 non-ICM heart failure patients were set as the non-ICM heart failure group,and 22 normal control patients were set as the normal control group.Enzyme-linked immunosorbent assay was used to detect the expression levels of Gal-3 and Nt-proBNP in the plasma of the four groups of patients,and the left atrial inner diameter(LAD)and left ventricular end-diastole were checked by echocardiography inner diameter(LVEDD),left ventricular ejection fraction(LVEF).Compare the four groups of general data,plasma Gal-3 levels,analyze the sensitivity and specificity of Gal-3 levels in the diagnosis of heart failure and ICM heart failure after myocardial infarction,and analyze the correlation between Gal-3 levels and cardiac function in the four groups.Results The Gal-3 levels of the four groups were compared,the difference was statistically significant(P<0.05).The Gal-3 level was the highest in the ICM heart failure group after central infarction.The level of Gal-3 in the ICM heart failure group after myocardial infarction was higher than that of the non-ICM heart failure group,non-ICM heart failure group,and normal control grou(P<0.05);The levels of Gal-3 in the ICM heart failure group and the non-ICM heart failure group after non-MI heart failure were higher than those in the normal control group(P<0.05);the non-ICM heart failure group and the non-ICM heart failure group after myocardial infarction,there was no statistically significant difference in the level of Gal-3(P>0.05);The ROC AUC of Gal-3 for the diagno

关 键 词：心肌梗死 缺血性心肌病 心力衰竭 半乳糖凝集素3 

分 类 号：R541.61[医药卫生—心血管疾病] R542.22[医药卫生—内科学]