宣玲，唐碧，康品方，张恒，王洪巨，赵皓



血清亲环素A与慢性心力衰竭的关系

宣玲，唐碧，康品方，张恒，王洪巨，赵皓

摘要

关键词亲环素A；利钠肽，脑； C反应蛋白质；心力衰竭

作者单位：233004 安徽省蚌埠市，蚌埠医学院第一附属医院 心血管科（宣玲、 唐碧、康品方、 张恒、王洪巨），中心实验室（赵皓）

Relationship Between Blood Levels of Cyclophilin A and Chronic Heart Failure

XUAN Ling,TANG Bi,KANG Pin-fang,ZHANG Heng,WANG Hong-ju,ZHAO Hao.
Department of Cardiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu(233004),Anhui China
Corresponding Author:XUAN Ling,Email:17893466@qq.com

Abstract

Objective:To explore the relationship between blood levels of cyclophilin A(CyPA)and chronic heart failure(CHF).

Methods:A total of 166 CHF patients were enrolled as CHF group,according to NYHA classification,it was further divided into 4 sub-groups:Class I,n=37,Class II,n=39,Class III,n=46 and Class IV,n=44.In addition,there was a Normal control group,n=52.Blood levels of CyPA,B-type natriuretic peptide(BNP)and high sensitivity C-reactive protein(hs-CRP)were examined and compared among different groups.

Results:Compared with Normal control group,CHF group had elevated CyPA(5.11 ± 2.43)ng/ml vs(2.28 ± 0.61)ng/ml,BNP(385.65 ± 184.06)pg/ml vs(90.37 ± 18.44)pg/ml and hs-CRP(11.74 ± 5.44)mg/L vs(5.99 ± 1.14)mg/L,all P<0.05.As increased severity of NYHA classification,blood levels of CyPA,BNP and hs-CRP between 2 subgroups had the increasing trend accordingly,all P<0.05;while there was an exception:blood levels of CyPA and hs-CRP were similar between Class I subgroup and Normal control group,all P>0.05.Pearson correlation analysis indicated that blood levels of CyPA were positively related to BNP and hs-CRP in CHF patients(r=0.838,P<0.01 and r=0.755,P<0.01).

Conclusion:Blood levels of CyPA were elevated in CHF patients and it’s obviously related to NYHA classification,which might have certain effects on CHF diagnosis and evaluation.

Key words Cyclophilin A;B-type natriuretic peptide;High sensitive C-reactive protein;Heart failure

(Chinese Circulation Journal,2016,31:223.)

中国心血管报告2013概要指出，我国心力衰竭患者有450万人[1]。慢性心力衰竭（CHF）是一种反复循环入院的疾病，其临床表现复杂、病情多变及预后比部分实体肿瘤和心肌梗死更差，已成为全球性的健康重负。最新研究表明，亲环素A参与心力衰竭的发生、发展，可作为心力衰竭预后的独立预测因子[2]，但国内对此研究尚少。B型利钠肽（BNP）对CHF患者有较好的临床诊断价值，是反映CHF患者严重程度的客观指标[3]。高敏C-反应蛋白（hs-CRP）是反映机体炎症状态的最敏感指标[4]。三者与心力衰竭程度关系尚少见报道，本研究通过联合检测血清亲环素A、BNP及hs-CRP水平，对血清亲环素A与CHF的关系进行初步探讨。

1　资料与方法

研究对象：CHF组为2014-06至2015-07在我科住院，且符合《中国心力衰竭诊断与治疗指南2014》诊断标准[5]的CHF患者166例，男93例，女73例，年龄28～91（67.60±12.39）岁，病程4～36年。排除急性心肌梗死、脑血管意外、肝肾疾病、感染及肿瘤。按纽约心脏协会（NYHA）心功能分级标准，心功能I、Ⅱ、Ⅲ及Ⅳ级患者分别为37、39、46及44例。收缩性心力衰竭153例，舒张性心力衰竭13例。病因分别为冠心病74例，高血压性心脏病32例，肺原性心脏病15例，心脏瓣膜病16例，心肌病26例，甲亢性心脏病2例，先天性心脏病1例。同时选取我院同期体检证实为健康者52例为正常对照组，年龄性别均与CHF组匹配，无高血压、冠心病、脑梗死、脑出血，无感染性疾病，无肝硬化、肝炎及肝肾功能损害，无肿瘤病史。……