摘要
目的分析慢性心力衰竭(CHF)患者血浆组织型金属蛋白酶抑制剂-4(TIMP-4)、可溶性E选择素(s ES)水平的变化及临床意义。方法选择2015年5月至2017年5月于东莞台心医院收治的CHF住院患者185例作为研究组(CHF组),根据纽约心功能(NYHA)分级进一步将CHF组分为心功能Ⅰ级组(n=30),心功能Ⅱ级组(n=59),心功能Ⅲ级组(n=63),心功能Ⅳ级组(n=33)。同期健康体检者50例作为对照组。对比各组血浆TIMP-4、s ES、B型脑钠肽(BNP)以及左室射血分数(LVEF)水平。分析TIMP-4与s ES水平与BNP及LVEF水平的相关性,以及TIMP-4、s ES对慢性心力衰竭患者的预测诊断效能。结果 CHF组患者血浆TIMP-4、LVEF水平显著低于对照组,其水平随着心功能分级的增加而显著下降;CHF组患者血浆sES、BNP水平显著高于对照组,其水平随着心功能分级的增加而显著升高,差异具有统计学意义(P<0.05)。Pearson相关系数显示,CHF患者血浆TIMP-4与BNP呈负相关(r=-0.743),与LVEF呈正相关(r=0.651);sES水平与BNP呈正相关(r=0.757),与LVEF呈负相关(Rs=-0.598)。TIMP-4、sES、BNP诊断CHF的ROC曲线下面积分别为0.918、0.732、0.895。三者联合诊断价值(AUC=0.985)显著高于单独BNP(AUC=0.895),特异性为89.9%,敏感度为95.3%。结论 TIMP-4与sES能有效反映CHF患者的病情程度,对CHF患者的诊断及病情评估具有较高的临床应用价值。
Objective To analyze the changes and clinical significance of levels of plasma tissue inhibitor of metalloproteinase-4(TIMP-4) and soluble E-selectin(sES) in patients with chronic heart failure(CHF). Methods CHF patients(n=185) were chosen(CHF group) from Dongguan Taixin Hospital from May 2015 to May 2017. The CHF group was further divided, according to NYHA classification of heart function, into group I(n=30), group II(n=59), group III(n=63) and group IV(n=33). At the same time the healthy controls(n=50) were chosen into control group. The levels of plasma TIMP-4 and sES, B-type natriuretic peptide(BNP) and left ventricular ejection fraction(LVEF) were compared among all groups. The correlation among TIMP-4 and sES, BNP and LVEF, and predictive value of TIMP-4 and sES to CHF diagnosis were analyzed. Results The levels of TIMP-4 and LVEF were significantly lower in CHF group than those in control group, and they decreased significantly along with the increase of NYHA classification of heart function. The levels of sES and BN were significantly higher in CHF group than those in control group, and they increased significantly along with the increase of NYHA classification of heart function(P<0.05). The results of Pearson correlation coefficient analysis showed that TIMP-4 was negatively correlated to BNP(r=-0.743) and positively correlated to LVEF(r=0.651) in CHF patients. The level of sES was positively correlated to BNP(r=0.757) and negatively correlated to LVEF(Rs=-0.598). The area under curve(AUC) of receiver operating characteristic(ROC) curve of TIMP-4 was 0.918, that of sES was 0.732 and that of BNP was 0.895 in CHF diagnosis. The diagnostic value of TIMP-4, sES and BNP combination(AUC=0.985) was significantly higher than that of BNP alone(AUC=0.895), and specificity was 89.9% and sensitivity was 95.3%.Conclusion TIMP-4 and sES can effectively reflect the severity of CHF in CHF patients with higher clinical value to the diagnosis and severity review of CHF.
作者
王怀龙
李格丽
唐超
嵇发明
聂素琴
许峰
Wang Huailong;Li Geli;Tang Chao;Ji Faming;Nie Suqin;Xu Feng(Department of Cardiovascular Medicine, Dongguan Taixin Hospital, Dongguan 452000, China)
出处
《中国循证心血管医学杂志》
2019年第6期702-704,708,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
广东省东莞市科技局发展计划医疗卫生(一般)项目(201650715011316)
