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慢性充血性心力衰竭患者CA125水平的意义。与临床和超声心动图参数的相关性。

The significance of CA125 levels in patients with chronic congestive heart failure. Correlation with clinical and echocardiographic parameters.

作者信息

Kouris Nikos T, Zacharos Ioannis D, Kontogianni Dimitra D, Goranitou Georgia S, Sifaki Maria D, Grassos Haris E, Kalkandi Eleni M, Babalis Dimitris K

机构信息

Cardiology Department, Western Attica General Hospital, Athens, Greece.

出版信息

Eur J Heart Fail. 2005 Mar 2;7(2):199-203. doi: 10.1016/j.ejheart.2004.07.015.

Abstract

OBJECTIVE

To assess serum levels of carbohydrate antigen 125 (CA125) in patients with chronic congestive heart failure (CHF) and to assess any correlation with clinical symptoms and echocardiographic indices.

PATIENTS AND METHODS

We enrolled 77 male patients (mean age: 73+/-10 years) admitted to the Cardiology Emergency Department (ED) with cardiac symptoms requiring hospitalization. Diagnosis of CHF was based upon medical history or initial echocardiographic evaluation on current admission. Serum CA125 was measured by an enzyme immunoradiometric assay, on admission and before discharge.

RESULTS

The median overall CA125 value was 22.4 (11.5-48.9) U/ml. Serum CA125 levels were related to the severity of CHF [New York Heart Association (NYHA) class I: 19.2 (7.2-31) U/ml, NYHA class II: 17.6 (10-23) U/ml, NYHA class III: 32 (25-77) U/ml and NYHA class IV: 34.3 (18.6-77) U/ml (p<0.04)]. Patients in NYHA classes III and IV had significantly higher mean values of CA125, than patients in class II (p<0.005 and p<0.05, respectively). Moreover, patients with fluid congestion (pulmonary congestion, ankle edema) had higher levels of serum CA125 than patients without congestion (p=0.002 and p<0.03, respectively). Finally, levels of serum CA125 correlated weakly with right ventricular systolic pressure (RVSP) and renal function, while no significant correlation was found between CA125 and E wave deceleration time on Doppler echocardiography, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), liver function and the medical treatment prescribed.

CONCLUSION

Serum CA125 is associated with the clinical severity of CHF and the symptoms and signs of fluid congestion and therefore may be a useful additional tool for the evaluation and clinical staging of these patients.

摘要

目的

评估慢性充血性心力衰竭(CHF)患者血清糖类抗原125(CA125)水平,并评估其与临床症状及超声心动图指标的相关性。

患者与方法

我们纳入了77例因心脏症状需住院治疗而入住心脏病急诊科(ED)的男性患者(平均年龄:73±10岁)。CHF的诊断基于病史或本次入院时的初始超声心动图评估。入院时及出院前采用酶免疫放射分析测定血清CA125。

结果

CA125总体中位数为22.4(11.5 - 48.9)U/ml。血清CA125水平与CHF严重程度相关[纽约心脏协会(NYHA)I级:19.2(7.2 - 31)U/ml,NYHA II级:17.6(10 - 23)U/ml,NYHA III级:32(25 - 77)U/ml,NYHA IV级:34.3(18.6 - 77)U/ml(p<0.04)]。NYHA III级和IV级患者的CA125平均值显著高于II级患者(分别为p<0.005和p<0.05)。此外,有液体潴留(肺淤血、踝部水肿)的患者血清CA125水平高于无液体潴留的患者(分别为p = 0.002和p<0.03)。最后,血清CA125水平与右心室收缩压(RVSP)及肾功能呈弱相关,而在多普勒超声心动图上CA125与E波减速时间、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、肝功能及所开药物治疗之间未发现显著相关性。

结论

血清CA125与CHF的临床严重程度以及液体潴留的症状和体征相关,因此可能是评估这些患者及进行临床分期的有用辅助工具。

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