Objective To study the association of serum CA125 level and heart function in elderly with chronic heart failure (CHF). Methods The levels of serum CA125, several tumour markers (CEA, AFP, CA199, CA15-3,CA724), AST, ALT, creatinine (Cr), blood urea nitrogen (BUN), uric acid (UA) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured in 152 elderly male CHF patients. Echocardiographic records including Ve, Va, Ve/Va, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and LV ejection time were analyzed. The patients were divided into three groups based on New York Heart Association (NYHA) Classification: class Ⅰ - Ⅱ group, class Ⅲ group and class Ⅳ group. Results ( 1 ) Only CA125 and NT-proBNP seemed to be specifically related to the severity of heart failure. CA125 and NT-proBNP levels increased with the NYHA functional class [Class Ⅰ-Ⅱ group: 10.2 (3.43-32.3) × 103U/L; Class Ⅲ group: 54.5 (35.0-179. 3) × 103U/L; Class Ⅳ group: 88.9 (20. 2-459. 1) × 103U/L, P ＜ 0.05 ]. There were no significant differences in other tumour marker levels among 3 groups. (2) Serum CA125 levels ( × 103U/L) in patients with pleural effusion, atrial fibrillation or peripheral edema were significantly higher than those without above characteristics [78.2 (32.4-459.6) vs. 11.3 (3.4-38.9), 67.7 (32.5-321.1) vs. 10.3(3.5-34.6), 45.6(32.6-213.7) vs. 11.5(3.6-35.4), all P ＜ 0. 01 ]. ( 3 ) Serum CA 125 levels were negatively correlated with LVEF ( r= - 0. 3016, P= 0. 006), LV ejection time ( r= - 0. 3336, P= 0. 004 ), and positively correlated with NT-proBNP ( r= 0. 3537, P= 0. 002 ).Conclusions Serum CA125 level reflects the severity of CHF and relates to NT-proBNP, LVEF and LV ejection time.%目的 探讨老年充血性心力衰竭(CHF)患者血清肿瘤相关抗原125(CA125)水平与心功能等相关因素间的关系.方法 测定152例老年CHF患者血清肿瘤标志物CA125、癌胚抗原(CEA)、甲胎蛋白(AFP)、CA199、CA15-3和CA724,以及血清肌酐(Cr)、尿素氮(BUN)、尿酸(UA)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)和N末端脑钠肽(NT-proBNP)水平;超声心动检测二尖瓣舒张早期E峰最大流速(Ve)、舒张晚期A峰最大流速(Va)、Ve/Va、左心室舒张末内径、左心室收缩末内径、左心室射血分数(LVEF)和左心室射血时间.所有患者根据纽约心脏病协会心功能分级分为Ⅰ～Ⅱ、Ⅲ、Ⅳ级3组;又根据症状分为胸腔积液和无胸腔积液组,外周水肿和无外周水肿组,心房颤动和无心房颤动组.结果 (1)血清CA125水平心功能Ⅰ～Ⅱ级组10.2(3.4～32.3)×103U/L、心功能Ⅲ级组54.5(35.0～179.3)×103U/L、心功能Ⅳ级组88.9(20.2～459.1)×103U/L;心功能Ⅳ级组CA125及NT-proBNP水平高于Ⅲ级组,Ⅲ级组又高于Ⅰ～Ⅱ级组,差异均有统计学意义(均为P<0.05);但随着心功能恶化,其他肿瘤标志物水平未见明显变化;(2)CA125水平(×103U/L)胸腔积液组高于无胸腔积液组[78.2(32.4～459.6)比11.3(3.4～38.9),P<0.01];外周水肿组高于无外周水肿组[67.7(32.5～321.1)比10.3(3.5～34.6),P<0.01];心房颤动组高于无心房颤动组[45.6(32.6～213.7)比11.5(3.6～35.4),P<0.01];(3)血清CA125与NT-proBNP水平呈正相关(r=0.3537,P=0.002),与LVEF(r=-0.3016,P=0.006)、左心室射血时间(r=-0.3336,P=0.004)呈负相关.结论 老年CHF患者血清CA125及NT-proBNP水平随着心功能恶化而升高,并且血清CA125水平与LVEF、左心室射血时间相关.
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