血清糖类抗原125对动脉性肺动脉高压严重程度及预后的相关性研究  

Correlation of serum carbohydrate antigen 125 with severity and prognosis of pulmonary arterial hypertension

作　　者：冯蕊 范庆坤 李玲[1] 张李涛 陈硕 张真路 FENG Rui;FAN Qingkun;LI Ling;ZHANG Litao;CHEN Shuo;ZHANG Zhenlu(Laboratory Medical Center,Wuhan Asia Heart Hospital Affiliated to Wuhan University of Science and Technology,Wuhan,Hubei 430022,China;School of Medicine,Wuhan University of Science and Technology,Wuhan,Hubei 430081,China;Department of Cardiac Surgery,Wuhan Asia Heart Hospital Affiliated to Wuhan University of Science and Technology,Wuhan,Hubei 430022,China)

机构地区：[1]武汉科技大学附属武汉亚洲心脏病医院检验医学中心,湖北武汉430022 [2]武汉科技大学医学院,湖北武汉430081 [3]武汉科技大学附属武汉亚洲心脏病医院心外科,湖北武汉430022

出　　处：《临床肺科杂志》2024年第6期842-847,853,共7页Journal of Clinical Pulmonary Medicine

基　　金：湖北省自然科学基金项目(No.2020CFB865)。

摘　　要：目的 探讨血清糖类抗原125(CA125)在动脉性肺动脉高压(PAH)患者中的表达水平,分析其与PAH严重程度及预后的关系。方法 前瞻性研究纳入2022年1月至2023年6月于武汉亚洲心脏病医院就诊的87例PAH患者,40例非PAH心脏病患者(疾病对照组)和90例于我院体检的健康人(健康对照组)。收集所有患者入院当天的血清样本,记录患者的临床资料。采用受试者工作特征(ROC)曲线下面积(AUC)评估CA125、NT-proBNP对PAH患者发生临床恶化事件的预测效能,通过Cox风险比例回归及Kaplan-Meier生存分析评估CA125在PAH患者预后中的临床价值。结果 PAH组患者的血清CA125水平高于疾病对照组和健康对照组(P<0.05),并随着NYHA心功能分级的增加而进一步表达(P<0.001)。血清CA125与PAH患者的NT-proBNP、NYHA心功能分级、mRAP呈正相关,与6MWD呈负相关(P<0.05)。通过ROC曲线分析,NT-proBNP联合CA125预测PAH患者预后的效能优于单独使用NT-proBNP,但两者差异无统计学意义(P>0.05)。中位随访384(244,414)天,经多变量Cox分析后显示CA125>19.4U/mL(HR=4.317,95%CI 1.875~9.940,P<0.001),LVEF(HR=0.895,95%CI 0.843~0.950,P<0.001),RVED(HR=1.531,95%CI 1.153~2.034,P=0.003)与临床恶化风险增加有关。结论 PAH患者的血清CA125水平升高,并与PAH患者的严重程度及不良预后相关,是加入多参数危险分层的有希望的生物标志物。Objective To investigate the expression level of serum carbohydrate antigen 125(CA125)in patients with pulmonary arterial hypertension(PAH),and to analyze its relationship with the severity and prognosis of PAH.Methods The prospective study enrolled a total of 87 patients with PAH,40 patients with non-PAH heart disease(the disease control group),and 90 healthy individuals(the healthy control group).These participants were admitted to Wuhan Asia Heart Hospital from January 2022 to June 2023.Serum samples were collected from all patients on the day of admission,and their clinical data were recorded.The predictive efficacy of CA125 and NT-proBNP for clinical deterioration events in patients with PAH was evaluated by the area under the curve(AUC)of receiver′s operating characteristics(ROC).The clinical value of CA125 in assessing the prognosis of patients with PAH was assessed by Cox proportional regression and Kaplan-Meier survival analysis.Results The level of serum CA125 in the PAH group was higher than the disease control group and the healthy control group(P<0.05).Furthermore,there was a significant increase in serum CA125 with the progression of NYHA functional classification(P<0.001).In patients with PAH,serum CA125 showed a positive correlation with NT-proBNP,NYHA functional classification,and mRAP,while it showed a negative correlation with 6MWD(P<0.05).The combination of NT-proBNP and CA125 had shown improved efficacy in predicting the prognosis of patients with PAH compared to NT-proBNP alone,but there was no statistical difference between them(P>0.05).After a median follow-up of 384(244,414)days,CA125>19.4U/mL(HR=4.317,95%CI 1.875~9.940,P<0.001),LVEF(HR=0.895,95%CI 0.843~0.950,P<0.001),RVED(HR=1.531,95%CI 1.153~2.034,P=0.003)were related to the increased risk of clinical deterioration.Conclusion The serum CA125 level in patients with PAH is increased,which is related to the severity and poor prognosis of PAH patients.It is a promising biomarker to add multi-parameter risk stratification.

关 键 词：糖类抗原125 N-末端脑利钠肽前体 动脉性肺动脉高压 超声心动图 右心导管检查 平均右心房压力 预后 

分 类 号：R544.1[医药卫生—心血管疾病]