摘要
目的观察老年慢性心力衰竭(CHF)患者血清高敏肌钙蛋白Ⅰ(hsTnⅠ)、基质金属蛋白酶9(MMP-9)、可溶性生长刺激表达基因2蛋白(sST2)水平变化,并分析其临床意义。方法选取2019年4月至2021年8月许昌市立医院收治的104例老年CHF患者为研究对象,入组当天检测血清hsTnⅠ、MMP-9、sST2水平,观察不同心力衰竭严重程度血清表达情况,分析其与超声心动图参数[心率(HR)、左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、平均脉动压(MAP)、左室舒张末期内径(LVEDD)]的相关性,对比不同心血管事件发生情况(68例非事件组、36例事件组)CHF患者血清hsTnⅠ、MMP-9、sST2水平及超声心动图参数,分析血清相关指标水平对CHF患者预后不良的预测价值。结果不同心力衰竭严重程度CHF患者血清hsTnⅠ、MMP-9、sST2水平及超声心动图参数HR、LVEF、LVEDV、MAP、LVEDD对比,差异有统计学意义(P<0.05);血清hsTnⅠ与HR、LVEDV、MAP、LVEDD呈正相关(P<0.05),与LVEF呈负相关(P<0.05);血清MMP-9与HR、LVEDV、MAP、LVEDD呈正相关(P<0.05),与LVEF呈负相关(P<0.05);血清sST2与HR、LVEDV、MAP、LVEDD呈正相关(P<0.05),与LVEF呈负相关(P<0.05);血清hsTnⅠ(95%CI:0.714~0.958)、MMP-9(95%CI:0.842~0.980)、sST2(95%CI:0.668~0.836)水平预测CHF患者心血管事件的曲线下面积、灵敏度、特异度均较高。结论CHF患者血清hsTnⅠ、MMP-9、sST2水平与超声心动图及出院后心血管事件有关,检测血清hsTnⅠ、MMP-9、sST2水平可预测心血管事件发生情况,对于评估病情有重要临床意义。
Objective To observe the changes of serum high-sensitivity troponinⅠ(hsTnⅠ),matrix metalloproteinase 9(MMP-9),soluble growth stimulated expression gene 2 protein(sST2)levels in elderly patients with chronic heart failure(CHF),and analyze their clinical significance.Methods One hundred and four elderly patients with CHF admitted to Xuchang Municipal Hospital from April 2019 to August 2021 were selected for the study,and serum hsTnⅠ,MMP-9,and sST2 levels were measured on the day of enrollment.The serum expression of different heart failure severity were observed.Correlations with echocardiographic parameters[heart rate(HR),left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),mean arterial pressure(MAP),left ventricular end-diastolic internal diameter(LVEDD)]were analyzed,and serum hsTnⅠ,MMP-9,sST2 levels and echocardiographic parameters of CHF patients with different cardiovascular events(68 non-event and 36 event groups)were compared.The predictive value of serum levels of relevant indexes for poor prognosis in patients with CHF were analyzed.Results Serum hsTnⅠ,MMP-9,sST2 levels and echocardiographic parameters HR,LVEF,LVEDV,MAP and LVEDD were statistically significant(P<0.05)when compared in patients with CHF of different heart failure severity.Serum hsTnⅠwas positively correlated with HR,LVEDV,MAP and LVEDD(P<0.05)and negatively correlated with LVEF(P<0.05).Serum MMP-9 positively correlated with HR,LVEDV,MAP and LVEDD(P<0.05)and negatively correlated with LVEF(P<0.05).Serum sST2 positively correlated with HR,LVEDV,MAP and LVEDD(P<0.05)and negatively correlated with LVEF(P<0.05).The area under curve,sensitivity,and specificity of serum hsTnⅠ(95%CI:0.714-0.958),MMP-9(95%CI:0.842-0.980)and sST2(95%CI:0.668-0.836)levels to predict cardiovascular events in patients with CHF were high.Conclusion Serum hsTnⅠ,MMP-9 and sST2 levels in CHF patients are associated with echocardiographic and post-discharge cardiovascular events.The detection of serum hsTnⅠ,MMP-9 and sST2 l
作者
任书贤
田志广
许德贵
REN Shuxian;TIAN Zhiguang;XU Degui(Department of Cardiology,Xuchang Municipal Hospital,Xuchang 462600,China)
出处
《河南医学研究》
CAS
2022年第13期2373-2376,共4页
Henan Medical Research
