摘要
目的:探讨血清β_2微球蛋白(β_2-MG)水平对扩张型心肌病(DCM)患者预后的影响。方法:回顾性收集中国医科大学附属盛京医院心内科2013-06至2017-01期间因DCM心力衰竭住院患者101例资料,以患者入院时血清β_2-MG中位数为界值,将其分为高β_2-MG(>3.10 mg/L)组(n=49)及低β_2-MG(≤3.10mg/L)组(n=52),分析血清β_2-MG水平与左心房内径(LAD)的相关性,进一步随访并分析血清β_2-MG水平与DCM患者预后的关系。结果:高β_2-MG组的LAD比低β_2-MG组大[(53.43±12.35)mm vs (48.50±8.48)mm],差异有统计学意义(P<0.05)。校正多个潜在混淆因素后,血清β_2-MG与LAD(r=0.303,P=0.015)呈正相关关系。校正血超敏C反应蛋白、同型半胱氨酸、肌酐等因素后的多因素Cox回归分析表明,高血清β_2-MG水平是DCM患者预后的独立危险因素(HR=1.143,95%CI:1.001~1.304,P<0.05)。Kaplan-Meier分析提示,高β_2-MG组的生存率明显低于低β_2-MG组(χ~2=7.100,P=0.008)。结论:DCM患者血清β_2-MG水平与LAD呈正相关关系,高血清β_2-MG水平是DCM患者因心力衰竭再住院及心原性死亡的预测因素。
Objectives： Present research aims to explore the impact of the serum β2-microglobulin（β2-MG） level on the prognosis of patients with dilated cardiomyopathy（DCM）.Methods： Data from 101 heart failure patients due to DCM, who were hospitalized in our department between June 2013 and January 2017, were retrospectively analyzed. Patients were divided into high β2-MG（3.10 mg/L） group（n=49） and low β2-MG（≤3.10 mg/L） group（n=52） groups according the the serum β2-MG level at admission. The correlation between the serum β2-MG level and the left atrium diameter（LAD） was analyzed and the impact of serum β2-MG level on prognosis of DCM patients was further evaluated. Results： LAD value was significantly higher in the high β2-MG l group than in the low β2-MG group（[ 53.43±12.35]mm vs [48.50±8.48]mm, P〈0.05）. After adjustment for multiple potential confounding factors, a positive correlation between serum β2-MG and LAD（r =0.303, P =0.015） was revealed. After the adjustment for cofounders including hypersensitive C-reactive protein, homocysteine, and creatinine, multivariate Cox regression analysis showed that high serum β2-MG level was an independent risk factor for impaired prognosis in patients with DCM（HR=1.143, 95% CI：1.001-1.304, P〈0.05）. Kaplan-Meier analysis suggested that the survival rate of patients with high β2-MG levels was apparently lower than that of patients with low β2-MG levels（χ-2=7.100, P=0.008）. Conclusions： The Serum β2-MG level is positively correlated with LAD in patients with DCM, and the high serum β2-MG level is a predictor of re-hospitalization due to heart failure and cardiac death in patients with DCM.
作者
鲁广见
王传合
孙志军
LU Guang-jian;WANG Chuan-he;SUN Zhi-jun(Department of Cardiology,Shengjing Hospital of China Medical University,Shenyang（110000）,Liaoning,China)
出处
《中国循环杂志》
CSCD
北大核心
2018年第8期787-791,共5页
Chinese Circulation Journal
关键词
血清Β2微球蛋白
左心房内径
扩张型心肌病
预后
Serum β2-microglobulin
Left atrial diameter
Dilated cardiomyopathy
Prognosis
