【摘要】 目的研究不同心功能等级心力衰竭患者血半乳凝集素3(galectin-3)表达水平及其与心脏结构和功能的关系。方法选取96例慢性心力衰竭患者,按照美国纽约心脏病协会(NYHA)分级将患者分为Ⅰ级(16例)、Ⅱ级(21例)、Ⅲ～Ⅳ级(59例)。测定血清galectin-3及氨基末端脑钠肽前体(NT-proBNP)水平,用心脏彩色多普勒超声观察心脏结构和功能。对心功能Ⅲ～Ⅳ级患者给予正规抗心力衰竭治疗,于治疗前及治疗后1周测血清galectin-3和NT-proBNP水平。结果心功能Ⅲ～Ⅳ级组血NT-proBNP、galectin-3水平明显高于心功能Ⅱ级、Ⅰ级组(均P<0.05)。左心室射血分数(LVEF)≤40%组血NT-proBNP水平高于LVEF>40%组(LnNT-proBNP:8.31±1.64比7.54±1.32,P<0.05)。左心室舒张末期内径(LVEDD)>70mm组血galectin-3水平高于LVEDD 50～70mm组[(10.70±3.51)比(8.78±3.20)μg/L,P<0.05];LVEDD 50～70mm组血NT-proBNP、galectin-3水平高于LVEDD<50mm组[LnNT-proBNP(8.57±1.27)比(7.43±1.45),galectin-3(8.78±3.20)比(5.56±2.12)μg/L;均P<0.05]。相关性分析显示:galectin-3与NYHA分级、LVEDD呈正相关(rs=0.44,r=0.37,均P<0.05)。多元Logistic回归分析显示β受体阻滞剂类药物是降低galectin-3水平的因素(OR=0.073,P=0.003)。结论随着心功能恶化,血galectin-3水平逐渐升高。Galectin-3与左心室重构的进展有一定的相关性。抗心力衰竭治疗可影响galectin-3水平。更多还原

【Abstract】 Objective To investigate the association between plasma galectin-3 level and cardiac function in patients with heart failure (HF). MethodsNinety-six patients with New York Heart Association (NYHA) functional classification of ClassⅠ(n=16), ClassⅡ(n=21), Class Ⅲ-Ⅳ (n=59) were included in this study. Serum galectin-3, NT-proBNP were detected and cardiac function was evaluated by cardiac color Doppler ultrasound. Conventional anti-heart failure treatment was performed for those with NYHA functional classification of Ⅲ-Ⅳ. Levels of galectin-3 and NT-proBNP were examined before and one week after treatment. ResultsSignificant increases of NT-proBNP and galectin-3 were detected in HF patients with NYHA Class Ⅲ-Ⅳ compared with those of Class Ⅱ or ClassⅠ(P<0.05). NT-proBNP level in patients with left ventricular ejection fraction (LVEF)≤40% was higher than that in patients with LVEF>40% (LnNT-proBNP: 8.31±1.64 vs 7.54±1.32, P<0.05). The concentration of galectin-3 in patients with left ventricular internal diameter end-diastolic (LVEDD) of more than 70 mm was higher than those of LVEDD ranged from 50 to 70 mm [(10.70±3.51) vs (8.78±3.20)μg/L, P<0.05]. Moreover, the concentration of galectin-3 and NT-proBNP in patients with LVEDD of 50-70 mm were higher than those of LVEDD<50 mm [LnNT-proBNP (8.57±1.27) vs (7.43±1.45), galectin-3 (8.78±3.20) vs (5.56±2.12) μg/L; all P<0.05]. A positive correlation was observed between galectin-3 concentration and NYHA functionnal classification and LVEDD (r=0.44, P<0.05; r=0.37, P<0.05). Logistic regression analysis showed that using of β-blocker leaded to a decrease of galectin-3 (OR=0.073, P=0.003). Conclusion The concentration of galectin-3 increased with the deterioration of cardiac function. A close correlation was observed between galectin-3 concentration and left ventricular remodeling. The anti-heart failure treatment may has an effect on the concentration of galectin-3.更多还原