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与心衰发作相关的CV生物标志物

By LabMedica International staff writers
Posted on 22 Apr 2018
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心力衰竭的两种形式与正常心脏的对比图(图片蒙南卡罗莱纳医科大学惠赐)。
心力衰竭的两种形式与正常心脏的对比图(图片蒙南卡罗莱纳医科大学惠赐)。
近半心衰患者射血分数并未降低,而是保持不变,但是尚不完全清楚生物标志物与将来心衰亚型的关联。
 
射血分数正常性心力衰竭(HFpEF)是一种充血性心力衰竭,每次心跳从左心室泵出的量(射血分数)都大于50%。当左心室向机体泵出的血量少于正常量时,会发生射血分数减低性心力衰竭(HFrEF)。
 
一大组来自多国的科学家与荷兰格罗宁根大学医学中心(www.umcg.nl)合作,招募了22,756名参与者,分为四个基于社区的纵向队列,并测量了肾功能障碍、内皮功能障碍和炎症的几个生物标志物,另外还测量了钠尿肽和高灵敏肌钙蛋白。
 
检查了下列生物标志物:N末端B型钠尿肽前体或脑钠尿肽,高灵敏肌钙蛋白T或I (cTn),C反应蛋白(CRP),尿白蛋白与肌酐之比(UACR),肾素与醛甾酮之比,D-二聚体,纤维蛋白原,可溶的肿瘤抑制物,半乳糖凝集素-3,胱抑素C,纤溶酶原激活剂抑制剂1,白细胞介素6。
 
在四个队列的22756名参与者中,有12,087名女性,10,669名男性;年龄为60 ±13岁;在中值为12年的随访中,633名参与者发生HFpEF,841人发生HFrEF。与HFpEF显著相关的有两种生物标志物:UACR和钠尿肽;与高灵敏肌钙蛋白有暗示性相关。另一方面,反映肾功能障碍、内皮功能障碍和炎症的六个生物标志物与HFrEF发病相关,它们是钠尿肽、UACR、cTn、胱抑素C、D-二聚体和CRP。如果直接比较,那么钠尿肽、高灵敏肌钙蛋白和CRP与HFrEF的关联比与HFpEF的关联更密切。
 
该研究的论文发表于2018年3月1日的《JAMA心内科》杂志。作者总结说,肾功能障碍、内皮功能障碍和炎症的生物标志物与HFrEF发病相关。相较而言,只有钠尿肽和UACR与HFpEF相关。这些发现把将来的研究重点导向甄别HFpEF风险的新型生物标志物。
 
Related Links:

格罗宁根大学医学中心>>> www.umcg.nl

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