半乳糖凝集素-3在慢性充血性心力衰竭中的临床价值及与中医分型的相关性研究

目的初步探讨半乳糖凝集素-3（Gal-3）在慢性充血性心力衰竭（CHF）患者中的变化以及与中医辨证分型的相关性.方法将133例心功能Ⅱ级～Ⅳ级的慢性心力衰竭患者按不同心功能分级分为3组,另选取30名健康志愿者作为正常对照组.心力衰竭组于入院后即依据辨证标准,确定中医辨证类型.所有病例于入院后次日晨抽取静脉血,检测B型脑钠肽（BNP）、高敏C反应蛋白（hs-CRP）及Gal-3.治疗5 d～7 d后,其中53例复测BNP,根据BNP下降与否分组.结果心力衰竭组BNP、hs-CRP、Gal-3水平明显高于正常对照组（P〈0.01）,且随着心衰程度的加重而显著升高.Gal-3与BNP、hs-CRP呈较显著的正相关（r=0.710,P〈0.01;r=0.686,P〈0.01）,与病程之间呈弱相关性（r=0.390,P〈0.01）.Gal-3对诊断心衰也具有较高的价值.Gal-3水平与中医各证型之间具有良好的相关性,且从低到高依次为气阴两亏证、气虚血瘀证、阳虚水泛证.结论血清Gal-3水平能够客观地反映心衰程度,与BNP、hs-CRP具有良好相关性,在心衰诊断方面也具有一定价值.Gal-3水平能够客观反映心衰不同中医证型的轻重程度,可以作为心力衰竭中医辨证分型的客观化指标.

Evaluation of Galectin-3 for Chronic Congestive Heart Failure and its Syndrome Differentiation of TCM

Objective To evaluate the clinical significance of galectin -3 in chronic congestive heart failure and its syndrome differentiation of traditional Chinese medicine （TCM）. Methods One hundred and thirty three patients （pts） with chronic congestive heart failure were divided into three groups according to New York Heart Association （NYHA） functional classification （from degree II to IV）. All pts were evaluated by syndrome differentiation of TCM. In addition,,30 healthy persons were chosen as control group. Plasma levels of B - type natriuretic peptide （BNP）, serum levels of high - sensitive C - reactive protein （hs - CRP）, and galectin - 3 were measured and analyzed. Results Galeetin - ,3 levels were significantly higher in pts with heart failure compared with control group （P〈0.01）. In CHF group, the degree of exacerbation of cardiac insufficiency was associated with increase of serum concentra- tion of galeetin - 3. Blood level of galectin- 3 was strongly positively correlated with concentration of BNP and hs CRP （r=0. 710, P%0.01;r=0. 686,P〈0.01） ,but weakly positively correlated with course of heart failure （r=0. 390,P〈0.01）. High value of ga- lectin - 3 for diagnosis of heart failure was shown, but was slightly lower than that of BNP. Galectin -3 blood level was different in various syndromes of TCM in the patients with chronic heart failure, galectin -,3 level was gradually increased from syndrome of both qi and yin deficiency, to the highest level in syndrome of yang deficiency and water overflow,and increased intermediately in syndrome of qi deficiency and blood stasis. Conclusion Serum level of galectin - 3 was significantly correlated with degree of heart failure, and was well correlated with the level of BNP and hs - CRP. Our data showed potential utility of galectin - 3 as a useful marker for diagnosis of heart failure. Serum level of galectin - 3 was also correlated with the severity of heart failure by evaluation of syndrome differen- tiation of TCM,which showed that galectin- 3 might be one of objective standard during syndrome differentiation of TCM.