扩张型心肌病患者LVSI、MHR及Gal-3的临床意义及其与NYHA心功能分级的相关性分析

摘要 目的：研究扩张型心肌病（DCM）患者左心室球形指数（LVSI）、单核细胞计数与高密度脂蛋白胆固醇（HDL-C）比值（MHR）和血清半乳糖凝集素-3（Gal-3）的变化，并分析其与DCM患者心功能的关系。方法：选择2018年1月-2022年10月在我院接受治疗的DMC患者68例作为研究组，并选取同期50例健康体检者作为对照组。研究组患者根据出院6个月份是否发生主要不良心血管事件分为MACE组和No-MACE组。比较各组间左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）、LVSI、单核细胞计数、HDL-C、MHR以及血清Gal-3。结果：（1）研究组患者LVEF显著低于对照组，而研究组患者LVEDD、LVESD以及LVSI均显著高于对照组（P<0.05）。（2）研究组患者单核细胞计数、HDL-C、MHR以及Gal-3均显著高于对照组（P<0.05）。（3）不同心功能分级DCM患者LVEF、LVEDD、LVESD、单核细胞计数和HDL-C组间比较无显著差异（P>0.05），但LVSI、MHR和血清Gal-3组间比较差异显著（P<0.05）。（4）MACE组患者LVSI、MHR和Gal-3均显著高于No-MACE组患者（P<0.05）。结论：LVSI、MHR和血清Gal-3在扩张型心肌病患者中升高，并与患者心功能分级有关，可作为DCM患者心功能恶化评价指标。

Clinical Significance of LVSI, MHR, and Gal-3 in Patients with Dilated Cardiomyopathy and Their Correlation with NYHA Cardiac Function Grading

ABSTRACT Objective: To study the changes of left ventricular sphericity index (LVSI), ratio of monocyte count to high-density lipoprotein cholesterol (HDL-C) (MHR) and serum galactose agglutinin 3 (Gal-3) in patients with dilated cardiomyopathy (DCM), and analyze their relationship with cardiac function in patients with DCM. Methods: 68 DMC patients who received treatment in our hospital from January 2018 to October 2022 were selected as the study group, and 50 healthy individuals in the same period were selected as the control group. The study group patients were divided into the MACE group and the No MACE group based on whether they had major adverse cardiovascular events within 6 months of discharge. Compare left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), LVSI, monocyte count, HDL-C, MHR, and serum Gal-3 between groups. Results: (1) The LVEF of the study group patients was lower than that of the control group, while the LVEDD, LVESD, and LVSI of the study group patients were significantly higher than those of the control group (P<0.05). (2) The monocyte count, HDL-C, MHR, and Gal-3 in the study group were higher than those in the control group (P<0.05). (3) There was no difference in LVEF, LVEDD, LVESD, monocyte count, and HDL-C among DCM patients with different functional grades (P>0.05), but there was a difference between LVS1, MHR, and serum Gal-3 groups (P<0.05). (4) The LVSI, MHR, and Gal-3 levels in the MACE group were higher than those in the No MACE group (P<0.05). Conclusion: LVSI, MHR, and serum Gal-3 are elevated in patients with dilated cardiomyopathy and are associated with cardiac function grading, which can be used as evaluation indicators for cardiac function deterioration in DCM patients.