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目的探讨血浆半乳糖凝集素-3(Gal-3)水平在慢性心肾综合征(CRS)患者中的诊断及其对预后判断的价值。方法选取2013年8月至2014年1月池州市人民医院心血管内科因慢性心力衰竭而住院的患者104例,记录入选者一般临床资料,将纽约心功能分级(NYHA)Ⅲ~Ⅳ级并且肾小球滤过率(c-a GFR)<60 m L·min-1·1.73 m-2分为CRS组(21例)和非CRS组(83例),均空腹检测血浆Gal-3、血清氨基末端脑钠肽前体(NT-pro BNP)、血清肌酐(Scr)以及血红蛋白(HGB)等水平,随访出院后3个月的再住院以及心血管终点事件的发生情况。结果 CRS组lg Gal-3水平为(2.17±0.42)ng/L,非CRS组lg Gal-3水平(1.58±0.39)ng/L,两组差异有统计学意义(P<0.05)。lg Gal-3与lg NT-pro BNP(r=0.520,P<0.05)、lg Scr(r=0.506,P<0.05)均呈正相关。多因素logistic回归分析显示,Gal-3为慢性CRS的独立危险因素(P<0.05)。CRS组随访3个月的再住院以及心血管终点事件发生率均明显高于非CRS组,差异有统计学意义(P<0.05)。根据ROC曲线,Gal-3诊断慢性CRS的曲线下面积为0.842,最佳的界值为79.84 ng/L,敏感性为81.0%,特异性为80.7%。结论血浆Gal-3在慢性CRS中具有一定的诊断价值,并可用于预测慢性CRS患者的短期预后。
Objective To investigate the diagnostic value of plasma Galectin-3 (Gal-3) in patients with chronic heart and kidney syndrome (CRS) and its prognostic value. Methods From August 2013 to January 2014, 104 cases of hospitalized patients with chronic heart failure in Department of Cardiology of Chizhou People ’s Hospital were enrolled. The clinical data of participants were recorded. NYHA class Ⅲ ~ Ⅳ and renal The GFR of 60 m L · min -1 · 1.73 m-2 was divided into two groups: CRS group (n = 21) and non-CRS group (n = 83) NT-proBNP, Scr and HGB were followed up for 3 months after hospital discharge and the occurrence of cardiovascular end point events. Results The level of lg Gal-3 was (2.17 ± 0.42) ng / L in CRS group and 1.58 ± 0.39 ng / L in non-CRS group (P <0.05). lg Gal-3 was positively correlated with lg NT-pro BNP (r = 0.520, P <0.05), lg Scr (r = 0.506, P <0.05). Multivariate logistic regression analysis showed that Gal-3 was an independent risk factor for chronic CRS (P <0.05). The 3-month rehospitalization and cardiovascular end point events in the CRS group were significantly higher than those in the non-CRS group (P <0.05). According to the ROC curve, the area under the curve of Gal-3 in diagnosing chronic CRS was 0.842, the best cutoff value was 79.84 ng / L, the sensitivity was 81.0% and the specificity was 80.7%. Conclusion Plasma Gal-3 is of diagnostic value in chronic CRS and can be used to predict the short-term prognosis of patients with chronic CRS.