扩张型心肌病患者血清缺血修饰白蛋白水平变化及其临床意义研究

摘要

Objective To analyze the change and clinical significance of serum ischemia modified albumin(IMA) level in patients with dilated cardiomyopathy.Methods From January 2015 to January 2017 in the Affiliated Hospital of Hebei University of Engineering,a total of 55 patients with dilated cardiomyopathy were selected as observation group,meanwhile 40 healthy people admitted to this hospital for physical examination were selected as control group.Family history of heart disease, serum levels of IMA,BNP and hs-CRP,LVEF and blood lipids index were compared between the two groups,serum levels of IMA,BNP and hs-CRP,and LVEF were compared in dilated cardiomyopathy patients with different NYHA grades,meanwhile correlations of serum IMA level with serum levels of BNP and hs-CRP,and LVEF were analyzed by Pearson correlation analysis. Results Proportion of patients with family history of heart disease,serum levels of IMA,BNP and hs-CRP in observation group were statistically significantly higher than those in control group,while LVEF,TC,HDL and LDL in observation group were statistically significantly lower than those in control group(P<0.05);no statistically significant differences of LDL/HDL ratio was found between the two groups(P>0.05).Serum levels of IMA,BNP and hs-CRP in dilated cardiomyopathy patients withⅢ- or Ⅳ-NYHA grade were statistically significantly higher than those in dilated cardiomyopathy patients with Ⅱ-NYHA grade,while LVEF in dilated cardiomyopathy patients withⅢ- or Ⅳ-NYHA grade was statistically significantly lower than that in dilated cardiomyopathy patients with Ⅱ-NYHA grade(P<0.05);serum levels of IMA,BNP and hs-CRP in dilated cardiomyopathy patients with Ⅳ-NYHA grade were statistically significantly higher than those in dilated cardiomyopathy patients with Ⅲ -NYHA grade,while LVEF in dilated cardiomyopathy patients with Ⅳ -NYHA grade was statistically significantly lower than that in dilated cardiomyopathy patients withⅢ-NYHA grade(P<0.05).Pearson correlation analysis results showed that,serum IMA level was positively correlated with serum levels of BNP(r=0.543) and hs-CRP(r=0.718) in patients with dilated cardiomyopathy,respectively(P<0.05),was negatively correlated with LVEF(r=-0.388,P<0.05).Conclusion Serum IMA level is significantly increased in patients with dilated cardiomyopathy,and it is closely correlated with cardiac function and inflammatory reaction.%目的 分析扩张型心肌病(DCM)患者血清缺血修饰白蛋白(IMA)水平变化及其临床意义.方法 选取2015年1月—2017年1月河北工程大学附属医院诊治的DCM患者55例作为观察组,另选取同期体检健康者40例作为对照组.比较两组受试者有心脏病家族史者所占比例,血清IMA、脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)水平,左心室射血分数(LVEF)及血脂指标;比较不同纽约心脏病协会(NYHA)分级DCM患者血清IMA、BNP、hs-CRP水平及LVEF;血清IMA水平与DCM患者血清BNP、hs-CRP水平及LVEF的相关性分析采用Pearson相关性分析.结果 观察组患者中有心脏病家族史者所占比例及血清IMA、BNP、hs-CRP水平高于对照组,LVEF及总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)水平低于对照组,差异有统计学意义(P<0.05);两组受试者LDL/HDL比值比较,差异无统计学意义(P>0.05).NYHA分级Ⅲ级和Ⅳ级DCM患者血清IMA、BNP、hs-CRP水平高于NYHA分级Ⅱ级DCM患者,而LVEF低于NYHA分级Ⅱ级DCM患者(P<0.05);NYHA分级Ⅳ级DCM患者血清IMA、BNP、hs-CRP水平高于NYHA分级Ⅲ级DCM患者,而LVEF低于NYHA分级Ⅲ级DCM患者(P<0.05).Pearson相关性分析结果显示,血清IMA水平与DCM患者血清BNP、hs-CRP水平呈正相关(r值分别为0.543、0.718, P<0.05),与LVEF呈负相关(r=-0.388,P<0.05).结论 DCM患者血清IMA水平明显升高,且其水平变化与心功能及炎性反应有关.