摘要
目的:探讨血清可溶性生长刺激表达因子2(sST2)、高敏心肌肌钙蛋白T(hs-cTnT)水平在评估慢性心力衰竭(心衰)程度及预后中的应用价值。方法:回顾性分析2018年1月至2019年10月在江油市人民医院住院的152例心衰患者的临床资料,根据心功能分级,分为心衰Ⅱ级组(n=51)、心衰Ⅲ级组(n=56)和心衰Ⅳ级组(n=45),纳入36例同期健康体检者作为对照组。记录所有研究对象左室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、血清sST2和hs-cTnT水平,采用Pearson相关性分析评估心衰患者血清sST2、hs-cTnT与LVEDD、LVEF的相关性。根据出院后3个月内主要心脏不良事件发生情况将心衰患者分为预后良好组和预后不良组,比较两组血清sST2、hs-cTnT水平差异,并使用受试者工作特征曲线(ROC曲线)评估血清sST2、hs-cTnT对心衰患者近期预后的预测价值。结果:心衰患者血清sST2、hs-cTnT与LVEDD呈正相关(r=0.455、0.342,P均<0.05),与LVEF呈负相关(r=-0.472、-0.366,P均<0.05)。出院后3个月,在152例心衰患者中,42例发生主要心脏不良事件,其中死亡8例,因心衰再入院34例,纳入预后不良组;其余纳入预后良好组。与预后良好组相比,预后不良组血清sST2[(107.18±31.74)ng/mL对(50.14±15.48)ng/mL]、hs-cTnT[(31.22±10.80)ng/L对(22.43±6.02)ng/L]较高(P<0.05);血清sST2、hs-cTnT及其联合检测对心衰患者近期不良预后均具有较高预测价值(AUC=0.95、0.76、0.95,P均<0.05),其截断值分别为71.43 ng/mL、29.78 ng/L。结论:血清sST2、hs-cTnT水平与心衰严重程度相关,可作为评估心衰近期预后的指标,临床应用价值较高。
Objective:To investigate the value of serum soluble suppression of tumorigenicity 2(sST2)and high-sensitivity cardiac troponin T(hs-cTnT)in evaluating the degree of chronic heart failure and prognosis.Methods:The clinical data of 152 inpatients with heart failure from January 2018 to October 2019 in Jiangyou People′s Hospital was retrospectively analyzed.According to the grades of cardiac function,the patients were divided into three groups,namely heart failure gradeⅡ(n=51),heart failure gradeⅢ(n=56),and heart failure gradeⅣ(n=45)group.And 36 people who had physical examination during the same period were set as control group.The left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),the levels of serum sST2 and hs-cTnT were recorded.Pearson correlation analysis was used to assess the correlation between serum sST2,hs-cTnT and LVEDD,LVEF.According to the occurrence of major adverse cardiac events(MACE)within 3 months after discharge,the patients were divided into good prognosis group and poor prognosis group.The serum sST2 and hs-cTnT levels were compared between the two groups.The value of serum sST2 and hs-cTnT levels on predicting the short-term prognosis in patients with heart failure was assessed by using receiver operating characteristic(ROC)analysis.Results:For patients with heart failure,serum sST2 and hs-cTnT levels were positively correlated with LVEDD(r=0.455,0.342,respectively,both P<0.05),and negatively correlated with LVEF(r=-0.472,-0.366,respectively,both P<0.05).Within three months after discharge,there were 42 cases of MACE,including 8 cases of deaths and 34 cases of rehospitalization due to heart failure,and they were set as poor prognosis group.The other patients without MACE were set as good prognosis group.Compared with good prognosis group,the serum sST2((107.18±31.74)ng/mL vs.(50.14±15.48)ng/mL)and hs-cTnT((31.22±10.80)ng/L vs.(22.43±6.02)ng/L)levels were higher in poor prognosis group(both P<0.05).The serum sST2,hs-cTnT and the combined detectio
作者
刘丽
张诗敏
LIU Li;ZHANG Shimin(Department of Cardiology,Jiangyou People′s Hospital,Sichuan621700,China)
出处
《国际心血管病杂志》
2020年第6期371-374,共4页
International Journal of Cardiovascular Disease
基金
四川省卫生厅科研课题(1100PJ358)。
关键词
慢性心力衰竭
心功能分级
预后
主要心脏不良事件
可溶性生长刺激表达因子2
高敏心肌肌钙蛋白T
Chronic heart failure
Cardiac function grades
Prognosis
Major cardiac adverse events
Serum soluble suppression of tumorigenicity 2
High-sensitivity cardiac troponin T
