| Objective:To investigate the expression of Gal-3 and PTX-3 in serum of pati ents with chronic heart failure before and after treatment,the correlation between Gal-3,PTX-3 and left ventricular function parameters and NYH A cardiac function classification.To analyze the diagnostic value of Gal-3 and PTX-3 in patients with chronic heart failure,and to provide new i deas for clinical diagnosis,risk stratification and guiding treatment of chr onic heart failure.Methods:Continuous selection of 105 patients with chronic heart failure whowere treated in Department of Cardiology of Affiliated Hospital of Che ngde Medical College from January 2015 to December 2015,diagnostic c riteria for heart failure with reference to the eighth edition of the textbo ok of internal medicine and the guidelines for the diagnosis and treatme nt of heart failure in China in 2014.According to the NYHA,the heart f unction classification was divided into gradeⅡ24 cases,grade Ⅱ35 cases,gradeⅣ46 cases.According to the basic heart disease divided into coron ary heart disease(CHD)45 cases,dilated cardiomyopathy(DCM)45 cases,hypertensive heart disease(HHD)15 cases.In the same period,45 cases h ealthy persons were selected as the normal control group.Detailed record s of the general situation of the selected persons,such as gender,age,wei ght,height,heart function classification,basic disease,past medical history,or al medication and other basic clinical data.Heart failure group: monitorin g of vital signs,observation of the symptom of dyspnea and jugular veno us distention,pulmonary rales,edema of lower extremity.BNP levels wer e detected in all the selected persons and in the heart failure group afte r 10 days of treatment,improved the check of cardiac ultrasound,blood r outine,liver and kidney function,blood lipid and ion.The serum samples were collected at the time of admission and 10 days after treatment in patients with heart failure,using ELISA to detect concentration,and carry on the statistics analysis.Results:1 Compared with the control group,serum Gal-3,PTX-3,BNP levels were significantly higher in heart failure group,the results were 6.12(5.45,6.70)ng/ml vs 4.83±0.72ng/ml;4.56(4.06,5.04)ng/ml vs 3.66(3.23,4.17)ng/m l;416.87(251.19,676.26)pg/ml vs 117.49(83.20,190.60)pg/ml,the differences were statistically significant(P<0.05).2 The levels of Gal-3,PTX-3 and BNP in the acute phase of the hear t failure group were significantly higher than those in the remission phase of heart failure group,the results were 6.12(5.45,6.70)ng/ml vs 5.07(4.59,5.58)ng/ml;4.56(4.06,5.04)ng/ml vs 4.14(3.74,4.51)ng/ml;416.87(251.19,676.26)pg/ml vs 199.53(125.41,315.04)pg/ml,the differences were statistically signif icant(P<0.05).3 With the increase of cardiac function classification,the level of Gal-3,PTX-3 and BNP were also increased in the heart failure group,the levels of serum Gal-3,PTX-3 and BNP were compared between cardiac functionⅡand cardiac function Ⅱ:4.92±0.39ng/ml vs 6.21(5.78,6.99)ng/ml,4.07±0.37ng/ml vs 4.69±0.53ng/ml,146.23(102.93,251.19)pg/ml vs 398.11(354.81,707.95)pg/ml,the differences were statistically significant(P<0.05);the levels of se rum Gal-3,PTX-3 and BNP were compared between cardiac functionⅡan d cardiac function:4.92±0.39ng/ml vs 6.34(5.94,6.80)ng/ml,4.07±0.37ng/ml v s 4.82(4.30,5.15)ng/ml,146.23(102.93,251.19)pg/ml vs 584.84±203.17pg/ml,th e differences were statistically significant(P<0.05);the levels of serum Gal-3,PTX-3 and BNP were compared between cardiac function Ⅱand cardiac functionⅣ:6.21(5.78,6.99)ng/ml vs 6.34(5.94,6.80)ng/ml,4.69±0.53ng/ml vs 4.82(4.30,5.15)ng/ml,398.11(354.81,707.95)pg/ml vs 584.84±203.17pg/ml,the differences of serum Gal-3,PTX-3 levels have no statistical significance(P =0.64,0.82>0.05),the difference of serum BNP level has statistical significa nce(P=0.008).4 Correlation analysis of Gal-3,PTX-3 and BNP,cardiac function classi fication,left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)in heart failure group,Gal-3 were positively correlated with cardiac function classification,LVEDD,BNP,PTX-3(r=0.735,0.538,0.835,0.543,P all<0.05),and negatively correlated with LVEF(r=-0.552,P<0.05);P TX-3 were positively correlated with cardiac function classification,LVEDD,BNP(r=0.569,0.448,0.566,P all<0.05),and negatively correlated with LVEF(r=-0.434,P<0.05);BNP were positively correlated with cardiac function classi fication,LVEDD(r=0.801,0.52,P all<0.05),and negatively correlated with LV EF(r=-0.512,P<0.05).5 ROC curve analysis showed that,the area under the ROC curve(A UC)of serum Gal-3 in the diagnosis of chronic heart failure was 0.858(P<0.05,95%CI was 0.801-0.915),sensitivity was 73.3% and specificity was 80.0%;the area under the ROC curve(AUC)of serum PTX-3 in the diagno sis of chronic heart failure was 0.821(P<0.05,95%CI was 0.749-0.894),sens itivity was 65.7% and specificity was 82.2%;the area under the ROC curv e(AUC)of serum BNP in the diagnosis of chronic heart failure was 0.897(P<0.05,95%CI was 0.850-0.945),sensitivity was 69.5% and specificity wa s 95.6%.The area under the ROC curve(AUC)of serum Gal-3+BNP in th e diagnosis of chronic heart failure was 0.900(P<0.05,95%CI was 0.853-0.947),sensitivity was 83.8% and specificity was 82.2%;the area under the R OC curve(AUC)of serum Gal-3+PTX-3 in the diagnosis of chronic heart failure was 0.887(P<0.05,95%CI was 0.836-0.938),sensitivity was 79.0% a nd specificity was 71.1%;the area under the ROC curve(AUC)of serum PTX-3+BNP in the diagnosis of chronic heart failure was 0.915(P<0.05,95%CI was 0.872-0.957),sensitivity was 82.9% and specificity was 77.8%;th e area under the ROC curve(AUC)of serum Gal-3+PTX-3+BNP in the diagnosis of chronic heart failure was 0.908(P<0.05,95%CI was 0.863-0.953),sensitivity was 85.7% and specificity was 80.0%.6 According to the basic heart disease divided into coronary heart dis ease group,dilated cardiomyopathy group,hypertensive heart disease group,th e serum levels of Gal-3,PTX-3 and lg BNP were compared between the t hree groups,the results were 6.03±0.88ng/ml vs 6.18±0.90ng/ml vs 5.89±0.79ng/ml;4.51±0.60ng/ml vs 4.63±0.547ng/ml vs 4.44±0.62ng/ml;2.58±0.31pg/ml vs 2.60±0.29pg/ml vs 2.54±0.28pg/ml,the differences were not statistical ly significant(P all>0.05).Conclusions:1 The serum Gal-3,PTX-3 and chronic heart failure are closely related,can reflect the severity of the disease in patients with heart failure,can be used as a new biomarker of heart failure.2 The levels of serum Gal-3,PTX-3 and BNP in patients with chronic heart failure were not related to the etiology of heart failure.3 Serum Gal-3 and PTX-3 can be used as important supplementary means of BNP and echocardiography,have a certain significance to the clin ical diagnosis,risk stratification and guiding treatment of chronic heart failu re,and multi index combined detection can effectively improve the diagnost ic efficiency of chronic heart failure. |
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