慢性心力衰竭患者心率震荡与血清糖类抗原125水平的测定及其临床意义

摘要

目的 探讨慢性心力衰竭(心衰)患者心率震荡(HRT)及血清糖类抗原125(CA125)水平的变化及其临床意义.方法 对心衰患者82例及对照组36例进行24h动态心电图、超声心动检查及CA125测定,比较2组患者震荡初始(TO)、震荡斜率(TS)及CA125水平的差异,比较不同心功能分级下的TO、TS值及CA125水平并分析TO、TS及CA125与LVEF的相关性.结果 心衰组的TO值高于对照组[(-0.31±0.07)％比(-1.31±0.13)％],TS值低于对照组[(2.05±0.21) ms/R-R间期比(7.76±1.86) ms/R-R间期],CA125高于对照组[(80.2±9.8) U/ml比(21.3±5.3) U/ml,均P＜0.05]；按照纽约心脏病学会心功能分级标准,分级水平越高,TO值越高、TS值越低、CA125水平越高；TO、TS及CA125与LVEF显著相关.结论 慢性心力衰竭患者心率震荡现象明显受损,CA125表达明显增多,并与心力衰竭的严重程度相关.%Objective To study the changes and clinical significance of heart rate turbulence (HRT) and serum carbohydrate antigen(CA125) levels in patients with chronic heart failure.Methods 24 h holter ECG recording,echocardiography and level of CA125 were examined in 82 patients with heart failure(HF) and 36 in the comparison group.Turbulence onset(TO) and turbulence slope (TS) were calculated from Holter recordings.The mean value of TO,TS and CA125 between the two groups were compared; TO,TS and serum CA125 levels in different New York Heart Association Classifications were also compared; the relativity between TO,TS,CA125 and LVEF was analyzed as well.Results TO is significantly higher in the HF group compared with the comparison group[( -0.31 ±0.07)％ vs ( -1.31 ±0.13)％,P=0.008) ],TS in the HF group is significantly lower[(2.05 ±0.21) ms/R-R vs (7.76 ± 1.86)ms/R-R,P=0.0006)],and CA125 levels are significantly higher[(80.2 ±9.8 ) U/ml vs (21.3 ± 5.3 ) U/ml,P =0.006) ].The difference of HRT and serum CA 125 levels for patients in different NYHA classification is significant.TO,TS and CA125 levels are significantly related to LVEF.Conclusion The existence of heart rate turbulence is significantly impaired in patients with chronic heart failure and serum CA125 levels of patients with HF rise as well which reflects well the severity of HF.