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目的:探讨血浆心肌营养素-1(CT-1)在老年慢性心力衰竭(CHF)患者中的作用和临床意义。方法:应用酶联免疫吸附测定法(ELISA)测定21例老年健康人(对照组)、69例老年CHF患者(CHF组,NYHAⅡ级22例,Ⅲ级27例,Ⅳ级20例)血浆CT-1、脑钠素(BNP)水平,同时采用超声心动图测定左室射血分数(LVEF)评定患者心功能。结果:CHF组血浆CT-1、BNP水平与对照组比较明显升高,差异具有统计学意义(t=5.824,P<0.01;t=6.062,P<0.01)。CHF组组间比较,各组CT-1水平差异均具有统计学意义(F=52.607,P<0.01),NYHAⅣ级组CT-1水平明显高于NYHAⅢ级组、NYHAⅡ级(P<0.05或P<0.01),NYHAⅢ级组明显高于NYHAⅡ级(P<0.05)。直线相关分析显示,CHF组血浆CT-1与BNP、心功能分级呈正相关(r=0.753,P<0.01或r=0.523,P<0.01),与LVEF呈负相关(r=-0.581,P<0.01)。通过绘制CT-1的ROC曲线,CT-1在ROC曲线下的面积为0.92,95%的可信区间为0.864～0.976,曲线下面积差异有统计学意义(P<0.01)。结论:老年CHF患者血浆CT-1水平明显升高,且与BNP、NYHA分级、LVEF具有较好的相关性。联合检测老年CHF患者血浆CT-1、BNP水平有助于CHF诊断及判断预后。
Objective: To investigate the role and clinical significance of plasma cardiotrophin-1 (CT-1) in elderly patients with chronic heart failure (CHF). Methods: Serum CT-PCR was performed in 21 elderly healthy people (control group), 69 elderly CHF patients (CHF group, NYHA class Ⅱ 22 cases, grade Ⅲ 27 cases, Ⅳ class 20 cases) by enzyme-linked immunosorbent assay (ELISA) 1, BNP levels, and the left ventricular ejection fraction (LVEF) was measured by echocardiography. Results: The levels of plasma CT-1 and BNP in CHF group were significantly higher than those in control group (t = 5.824, P <0.01; t = 6.062, P <0.01). The levels of CT-1 in NYHAⅣgroup were significantly higher than those in NYHAⅢgroup and NYHAⅡgroup (P <0.05 or P <0.05) <0.01). NYHA Ⅲ group was significantly higher than NYHA Ⅱ group (P <0.05). Linear correlation analysis showed that there was a positive correlation between plasma CT-1 level and BNP and heart function grade in CHF group (r = 0.753, P <0.01 or r = 0.523, P <0.01) and negative correlation with LVEF 0.01). By plotting the ROC curve of CT-1, the area under the ROC curve of CT-1 was 0.92, and the 95% confidence interval was 0.864-0.976. The area under the curve showed a significant difference (P <0.01). Conclusion: The level of plasma CT-1 in elderly patients with CHF was significantly higher than that of BNP, NYHA classification and LVEF. Combined detection of plasma levels of CT-1 and BNP in elderly patients with CHF contributes to the diagnosis and prognosis of CHF.