徐鸣悦,
张明璇,
李忠艳^,
大连医科大学附属第二医院 心血管内科, 辽宁 大连 116027

基金项目: 大连市医学科学研究计划项目（1712042）


详细信息 作者简介: 徐鸣悦(1992-), 女, 博士研究生。E-mail: Xumingyue003@163.com



通讯作者: 李忠艳, 主任医师。E-mail: Lzyheart@aliyun.com 中图分类号: R541.6


摘要:目的探讨慢性心力衰竭（chronic heart failure，CHF）患者血清Ⅲ型前胶原氨基端肽（N-terminal peptide of type Ⅲ procollagen，PⅢNP）和半乳糖凝集素3（galectin-3，Gal-3）的相关性，评价两者在慢性心衰中的临床意义。方法选取大连医科大学附属第二医院心内科住院的心衰患者122例作为CHF组，非心衰患者51例作为对照组。分别测定两组患者的血清PⅢNP、Gal-3和NT-proBNP水平。采用心脏彩色多普勒超声检查，测定左心室舒张末期内径（LVEDD）和左心室射血分数（LVEF）。观察CHF患者血清PⅢNP、Gal-3水平变化，探究两者之间的相关性及其分别与NT-proBNP、LVEDD、LVEF的相关性。采用多元线性回归分析的方法分析影响CHF的因素。结果CHF组患者血清PⅢNP和Gal-3水平均明显高于对照组（均P < 0.01），CHF组患者PⅢNP和Gal-3水平与NT-proBNP水平正相关（分别为r=0.372，P < 0.01；r=0.418，P < 0.01），与LVEDD水平正相关（分别为r=0.338，P < 0.01；r=0.339，P < 0.01），与LVEF水平负相关（分别为r=-0.392，P < 0.01；r=-0.349，P < 0.01）。CHF组患者血清PⅢNP水平与Gal-3水平正相关（r=0.373，P < 0.01）。多元线性回归中，Gal-3、NT-proBNP、PⅢNP是LVEF独立的影响因素（P=0.024；P < 0.001；P < 0.001）；PⅢNP是LVEDD的独立影响因素（P=0.002）。结论PⅢNP、Gal-3水平在一定程度上可以反映CHF的严重程度及心肌纤维化情况，对评估CHF预后具有一定价值。
关键词: 慢性心力衰竭/
Ⅲ型前胶原氨基端肽/
半乳糖凝集素3


Abstract:ObjectiveTo investigate the relationship between serum levels of N-terminal peptide of type Ⅲ procollagen (PⅢNP), galectin-3 (Gal-3) and cardiac functional parameters and to evaluate their clinical significance in patients with chronic heart failure (CHF).MethodsA total of 122 hospitalized patients in 2nd Affiliated Hospital of Dalian Medical University were enrolled into CHF group and 51 patients without heart failure were enrolled into control group. Venous blood was obtained for examination of NT-proBNP, PⅢNP and Gal-3. The left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were measured by echocardiography. Serum levels of PⅢNP and Gal-3 in CHF patients were measured to determine the correlation with NT-proBNP, LVEDD and LVEF respectively. Multiple linear regression analysis was used to analyze risk factors of CHF.ResultsThe levels of serum PⅢNP and Gal-3 in CHF group were significantly higher than those in control group (P < 0.01). The levels of PⅢNP and Gal-3 in CHF group were positively correlated with NT-proBNP (r=0.372, P < 0.01; r=0.418, P < 0.01) and LVEDD (r=0.338, P < 0.01; r=0.339, P < 0.01), and negatively correlated with LVEF (r=-0.392, P < 0.01; r=-0.349, P < 0.01). The level of serum Gal-3 in CHF group was positively correlated with PⅢNP level (r=0.373, P < 0.01). Multiple linear regression analysis revealed that serum Gal-3, NT-proBNP and PⅢNP levels were independent risk factors for LVEF (P=0.024;P < 0.001;P < 0.001), and serum PⅢNP level was an independent risk factor for LVEDD (P=0.002).ConclusionsP Ⅲ NP and Gal-3 levels can, to some extent, reflect the severity of CHF and myocardial fibrosis, and are of value in assessing the prognosis of CHF.
Keywords:chronic heart failure/
N-terminal peptide of type Ⅲ procollagen/
galectin-3

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