摘要
目的:观察血清胰岛素样生长因子结合蛋白-7(IGFBP-7)、胰岛素样生长因子-1(IGF-1)和可溶性生长刺激表达基因2蛋白(sST-2)水平预测射血分数保留心力衰竭(HFpEF)1年内发生主要不良心血管事件(MACE)的效能。方法:选择2017年1月至2019年12月在我院诊治的HFpEF患者119例,为HFpEF组;选择同期在我院健康体检者45例,为对照组。采用酶联免疫吸附法检测各组患者血清IGFBP-7、IGF-1和sST-2水平。比较HFpEF组和对照组患者血清IGFBP-7、IGF-1、sST-2水平和左室射血分数(LVEF)的变化,观察血清IGFBP-7、IGF-1和sST-2水平与HFpEF患者心功能分级和左室舒张功能减退的关系,及其预测1年内发生MACE的灵敏度和特异性。结果:HFpEF组患者的血清IGFBP-7和sST-2水平高于对照组(P<0.01),血清IGF-1水平低于对照组(P<0.01),两组患者的LVEF水平差异无统计学意义(P>0.05)。血清IGFBP-7和sST-2水平随着HFpEF患者心功能分级和左室舒张功能障碍严重程度的升高而升高(P<0.01),预后不良组患者血清IGFBP-7和sST-2水平高于预后良好组(P<0.01);血清IGF-1水平随着心功能分级和左室舒张功能障碍严重程度的升高而降低(P<0.01),预后不良组患者血清IGF-1水平低于预后良好组(P<0.01)。血清IGFBP-7、IGF-1和sST-2水平预测1年内出现MACE具有较高的诊断效能,联合检测(IGFBP-7+IGF-1+sST-2)的灵敏度为89.2%,特异度为97.6,AUC为0.981,明显高于单个指标IGFBP-7(Z=2.928,P=0.003)、IGF-1(Z=4.060,P<0.001)和sST-2(Z=3.219,P=0.001),而各单个指标之间差异无统计学意义(P>0.05)。结论:血清IGFBP-7、IGF-1和sST-2水平参与了HFpEF疾病的发生发展,在预测1年内发生MACE方面具有重要临床价值。
Objective:To observe the value of serum insulin-like growth factor binding protein-7(IGFBP-7),insulin-like growth factor-1(IGF-1)and soluble growth stimulating expression gene 2(sST-2)in predicting major adverse cardiovascular events(MACE)of heart failure with preserved ejection fraction(HFpEF)within 1 year.Methods:119 patients with HFpEF who were diagnosed and treated in our hospital from January 2017 to December 2019 were selected as the HFpEF group.45 patients who had physical examination in our hospital during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to detect serum levels of IGFBP-7,IGF-1 and sST-2 in each group.The levels of serum IGFBP-7,IGF-1,sST-2 and LVEF were compared between the HFpEF group and the control group.The relationship between the serum IGFBP-7,IGF-1,sST-2 level and the cardiac function grading and decreased left ventricular diastolic function of patients with HFpEF,and the sensitivity and specificity of these indicators in predicting MACE within 1 year were observed.Results:The levels of serum IGFBP-7 and sST-2 in the HFpEF group were higher than those in the control group(P<0.01),while the serum IGF-1 level in the HFpEF group was lower than that in the control group(P<0.01).There was no statistical difference in LVEF levels between the two groups(P>0.05).The serum IGFBP-7 and sST-2 levels increased with the increasing of the grade of cardiac function and the severity of left ventricular diastolic dysfunction in patients with HFpEF(P<0.01).The levels of serum IGFBP-7 and sST-2 in the poor prognosis group were higher than those in the good prognosis group(P<0.01).The serum IGF-1 level decreased with the increasing of the grade of cardiac function and the severity of left ventricular diastolic dysfunction(P<0.01).The serum IGF-1 level in the poor prognosis group was lower than that in the good prognosis group(P<0.01).The serum levels of IGFBP-7,IGF-1 and sST-2 had high diagnostic efficiency in predicting MACE within 1 year.The combined dete
作者
李高楼
朱光霞
LI Gaolou;ZHU Guangxia(Department of Cardiology, Minhang District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200241, China;Department of Day Ward, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201112, China)
出处
《中国医药导刊》
2021年第6期401-406,共6页
Chinese Journal of Medicinal Guide
