摘要
目的评估可溶性人基质裂解素-2(sST2)与N端脑钠肽前体(NT-ProBNP)在不同类型心力衰竭患者中的表达及短期预后价值。方法回顾性分析104例慢性心力衰竭患者,收集患者入院时心力衰竭相关临床指标,根据左室射血分数(LVEF)水平分为三组:射血分数降低的心力衰竭(HFrEF)组(LVEF≤40%,n=34)、射血分数处于中间范围的心力衰竭(HFmrEF)组(LVEF 41%~49%,n=32)和射血分数保留的心力衰竭(HFpEF)组(LVEF≥50%,n=38),三组均随访观察6个月,研究终点是心脏事件死亡、心脏移植、心力衰竭加重再入院。分析sST2与NT-proBNP之间的相关性,使用ROC曲线评估不同标记物以及组合检测对预后不良事件的评估价值。结果三组患者在收缩压、LVEF、NT-proBNP、sST2、β受体阻滞剂和地高辛使用的比例上比较,差异均有统计学意义(F分别=26.25、266.91、75.54、40.69,χ^2分别=22.12、19.99,P均<0.05)。相关性分析结果显示,sST2与NTproBNP之间有相关性(r=0.64,P<0.05)。ROC曲线结果显示在HFmrEF组,sST2和NT-proBNP+sST2组合对短期预后不良事件均有较高的预测价值,且sST2+NT-proBNP组合的AUC值高于sST2和NT-proBNP的AUC值。在HFrEF组和HFpEF组,NT-proBNP、sST2和NT-proBNP+sST2组合对短期预后不良事件均有明显的预测价值。多因素分析显示NT-proBNP(OR=3.65,95%CI:1.21~7.82)和sST2(OR=4.39,95%CI:1.63~8.79)是不同类型慢性心力衰竭短期预后不良事件的预测因子。结论NT-proBNP和sST2均是不同类型慢性心力衰竭患者短期预后不良事件的独立预测因子。
Objective To evaluate the expression and short-term prognostic value of soluble suppression of tumorigenicity-2(sST2)and N-terminal pro B-type natriuretic peptide(NT-proBNP)in patients with different types of heart failure(HF).MethodsA retrospective analysis of 104 patients with chronic heart failure(CHF)was performed.According to the left ventricular ejection fraction(LVEF)level on admission,the patients were divided into three groups:heart failure(HFrEF)group with reduced ejection fraction(LVEF≤40%),heart failure(HFmrEF)group with ejection fraction in the middle range(LVEF 41%to 49%),and the heart failure fraction preserved heart failure(HFpEF)group(LVEF≥50%).All the three groups were followed up for 6 months.The study end point was cardiac event death,heart transplantation,heart failure and re-admission.The correlation between sST2 and NT-proBNP was analyzed,and the ROC curve was used to evaluate the value of different markers and combined detection for the prognostic adverse events.ResultsThe differences in systolic blood pressure,LVEF,NT-proBNP,sST2,and the proportion ofβ-blockers and digoxin were statistically significant(F=26.25,266.91,75.54,40.69,χ^2=22.12,19.99,P<0.05).Correlation analysis showed that there was a correlation between sST2 and NT-proBNP(r=0.64,P<0.05).The ROC curve showed that in the HFmrEF group,the sST2 and NT-proBNP combined with sST2 had higher predictive value for shortterm prognosis adverse events.The AUC value of the sST2 and NT-proBNP combination was higher than that of sST2 and NT-proBNP.In the HFrEF group and the HFpEF group,the NT-proBNP,sST2,and NTproBNP combined with sST2 had significant predictive value for short-term prognosis adverse events(P<0.05).Multivariate analysis showed that NT-proBNP(OR=3.65,95%CI:1.21~7.82)and sST2(OR=4.39,95%CI:1.63~8.79)were predict factors of short-term prognostic adverse events in different types of chronic heart failure.Conclusion Both NT-proBNP and sST2 are independent predictors of short-term prognostic adverse events in patients with
作者
余涌
YU Yong(Department of Critical Care Medicine,Tonglu Traditional Chinese Medicine Hospital,Tonglu 311500,China)
出处
《全科医学临床与教育》
2019年第9期792-796,共5页
Clinical Education of General Practice
关键词
可溶性人基质裂解素-2
N端脑钠肽前体
心力衰竭
预后评估
soluble suppression of tumorigenicity-2
N-terminal pro B-type natriuretic peptide
heart failure
prognostic assessment
