糖类抗原125水平对慢性心力衰竭患者新发心房颤动的预测价值

发布时间：2019-02-14 10:51

【摘要】：目的:探索血清糖类抗原125(CA-125)水平是否能够预测慢性心力衰竭(心衰)患者心房颤动(房颤)的发生。方法:入选2012-01至2016-01期间共200例既往和目前均无房颤的慢性心衰住院患者,经住院治疗病情稳定后检测其血清CA-125水平,并定期随访,观察房颤的发生情况,评估基线血清CA-125水平与新发房颤之间的关系。结果:8例患者在首次随访期(半年)内死亡,14例失访,故共178例患者完成至少一次随访。这些患者平均随访时间为(20.1±9.9)个月(6~54个月),其中40例(22%)患者出现新发房颤。与保持窦性心律的患者比较,新发房颤患者基线CA-125水平更高[108(44~228)U/ml vs 49(21~118)U/ml,P0.001]。受试者工作特征曲线显示,预测新发房颤的血清CA-125最佳截点为72.58 U/ml。单因素分析发现,血清CA-125水平72.58 U/ml、左心房内径增加、右心室扩大、肺动脉收缩压高、左心室射血分数低以及中到重度的二尖瓣反流对新发房颤有预测价值。校正单因素分析中有意义的变量后,多因素Cox回归分析发现,血清CA-125水平72.58 U/ml(风险比=2.709,95%可信区间:1.308~6.876,P=0.008)和中到重度的二尖瓣反流(风险比=2.301,95%可信区间:1.204~5.334,P=0.01)是新发房颤的独立预测因素。结论:血清CA-125水平与慢性心衰患者新发房颤相关;血清CA-125水平升高的慢性心衰患者更容易发生房颤。
[Abstract]:Aim: to investigate whether serum carbohydrate antigen 125 (CA-125) level can predict the occurrence of atrial fibrillation (AF) in patients with chronic heart failure (CHF). Methods: a total of 200 patients with chronic heart failure (CHF) were enrolled in the period from January 2012 to January 2016. The serum CA-125 levels were measured after stable hospitalization, followed up regularly to observe the occurrence of AF. To evaluate the relationship between baseline serum CA-125 levels and new atrial fibrillation. Results: eight patients died in the first follow-up period (half a year) and 14 patients lost the visit. 178 patients completed at least one follow-up. The mean follow-up time of these patients was (20.1 卤9.9) months (6-54 months), of which 40 (22%) had new atrial fibrillation. Baseline CA-125 levels in patients with new atrial fibrillation were higher than those with sinus rhythm [108 (44 / 228) U/ml vs 49 (21 / 118) U / ml / P 0.001]. The operating characteristic curve showed that the optimal cut-off point of serum CA-125 was 72.58 U / ml for new atrial fibrillation. Univariate analysis showed that serum CA-125 level was 72.58 U / ml, left atrial diameter increased, right ventricle enlarged, pulmonary artery systolic pressure high, left ventricular ejection fraction low and mitral regurgitation to moderate to severe mitral regurgitation. After adjusting for the significant variables in univariate analysis, multivariate Cox regression analysis showed that the serum CA-125 level was 72.58 U/ml (risk ratio = 2.709 卤95% CI: 1.308 卤6.876, P < 0.05). P0. 008 and moderate to severe mitral regurgitation (risk ratio = 2. 301 卤95% CI: 1. 204 / 5.334 / P0. 01) were independent predictors of new atrial fibrillation. Conclusion: the level of serum CA-125 is associated with new atrial fibrillation in patients with chronic heart failure, and the patients with chronic heart failure with elevated serum CA-125 level are more likely to develop atrial fibrillation.
【作者单位】：江苏大学附属医院心血管内科;
【分类号】：R541.6;R541.75

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