摘要
目的探讨不同NYHA心功能分级慢性心力衰竭患者血浆Elabela(ELA)表达水平差异及意义。方法慢性心力衰竭患者62例,其中NYHA心功能Ⅰ级17例,Ⅱ级14例,Ⅲ级18例,Ⅳ级13例,入院次日采集空腹静脉血,采用电化学发光法检测血浆N末端脑钠肽前体(nitrogen-terminal pro-brain natriuretic peptide,NT-proBNP)水平,采用ELISA法测定血浆ELA水平,应用彩色多普勒超声测定左室射血分数(left ventricular ejection fraction,LVEF);Spearman相关分析血浆ELA水平与NT-proBNP、LVEF的相关性。结果血浆ELA、NT-proBNP水平在NYHA心功能Ⅱ级患者[4.69(2.50,5.87)μg/L、1 022(776,1 760)ng/L]、Ⅲ级患者[8.66(6.81,9.65)μg/L、3 265(2 800,4 115)ng/L]、Ⅳ级患者[23.37(16.91,37.88)μg/L、7 817(6 959,9 636)ng/L]高于Ⅰ级患者[2.75(1.87,3.82)μg/L、318(219,537)ng/L],且NYHA心功能Ⅳ级患者高于Ⅱ级、Ⅲ级患者,Ⅲ级患者高于Ⅱ级患者(P<0.05);NYHA心功能Ⅲ、Ⅳ级患者LVEF水平[(37.33±4.63)%、(34.00±4.47)%]低于Ⅰ级患者[(45.25±4.44)%](P<0.05),Ⅲ级与Ⅳ级、Ⅰ级与Ⅱ级患者LVEF水平比较差异无统计学意义(P>0.05);Spearman相关分析结果显示,慢性心力衰竭患者血浆ELA水平与NT-proBNP呈正相关(r=0.86,P<0.001),与LVEF水平呈负相关(r=-0.61,P<0.001)。结论随NYHA心功能分级增高,慢性心力衰竭患者血浆ELA表达明显增高,血浆ELA可作为判断心力衰竭严重程度的生物学标志物。
Objective To observe the changes of plasma levels of Elabela(ELA)in different New York Heart Association(NYHA)class in patients with chronic heart failure.Methods Sixty-two patients with chronic heart failure were divided into NYHA classⅠ group(n=17),classⅡ group(n=14),classⅢ group(n=18)and class Ⅳ group(n=13). The plasma nitrogen-terminal pro-brain natriuretic peptide(NT-proBNP) was detected by electrochemiluminescence immunoassay,ELA was detected by ELISA,and left ventricular ejection fraction(LVEF)was determined by color Doppler ultrasound.Spearman correlation analysis was used to analyze the relationship of ELA with NT-proBNP and LVEF.Results The levels of NT-proBNP and ELA were the highest in NYHA classⅣ group(23.37(16.91,37.88)μg/L,7 817(6 959,9 636)ng/L),followed by NYHA classⅢ group(8.66(6.81,9.65)μg/L,3 265(2 800,4 115)ng/L),NYHA classⅡ group(4.69(2.50,5.87)μg/L,1 022(776,1 760)ng/L),and NYHA classⅠgroup(2.75(1.87,3.82)μg/L,318(219,537)ng/L)in turns(P<0.05).The LVEF level was significantly lower in NYHA classⅢ group((37.33±4.63)%)and NYHA classⅣ group((34.00±4.47)%)than that in NYHA classⅠgroup((45.25±4.44)%)(P<0.05),and showed no significant difference between NYHA classⅢ group andⅣ group and between NYHA class Ⅰ group and Ⅱ group(P>0.05).Spearman correlation analysis results showed that the plasma ELA level was positively correlated with NT-proBNP(r=0.86,P<0.001),and negatively correlated with LVEF in patients with chronic heart failure(r=-0.61,P<0.001).Conclusion The plasma ELA level increases obviously with the increase of NYHA classification,and it might be used as a sensitive biomarker for evaluating the severity of heart failure.
出处
《中华实用诊断与治疗杂志》
2017年第9期899-901,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金(81570365)
南京市医学科技发展项目(YKK10086)
