| 血清sST2、ACT-A及NT-proBNP在慢性心力衰竭病人病情发生及发展中的临床意义 |
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| 引用本文： | 李鸿渐,王思月.血清sST2、ACT-A及NT-proBNP在慢性心力衰竭病人病情发生及发展中的临床意义[J].蚌埠医学院学报,2022,47(11):1509-1512. |
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| 作者姓名： | 李鸿渐 王思月 |
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| 作者单位： | 山东省济南市人民医院 心内科, 271199 |
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| 基金项目： | 山东省自然科学基金项目ZR2014HL108 |
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| 摘 要： | 目的研究血清可溶性ST2（sST2）、激活素A（ACT-A）及N-末端脑钠肽前体（NT-proBNP）的表达及在慢性心力衰竭（CHF）病人病情发生发展中的临床意义。方法选取149例CHF病人为CHF组，以50名健康查体人群作为对照组。分析sST2、ACT-A、NT-proBNP的组间表达差异及三指标与临床参数的相关性。应用ROC曲线分析血清sST2、ACT-A、NT-proBNP对CHF病人心血管事件的预测价值。结果与对照组相比，CHF组病人血清sST2、ACT-A、NT-proBNP水平较高，而左心室射血分数（LVEF）水平较低（P < 0.01）。NYHA心功能分级Ⅳ级的CHF病人血清sST2、ACT-A、NT-proBNP高于Ⅲ级，且Ⅲ级高于Ⅱ级（P < 0.05）。CHF组病人血清sST2、ACT-A、NT-proBNP水平与NYHA分级呈明显正相关关系（P < 0.05），与LVEF呈明显负相关关系（P < 0.05），与年龄、TC、TG、hsCRP、HDL-C、LDL-C、hs-CRP、HbA1c无明显相关关系（P>0.05）。ROC曲线分析结果显示，sST2、ACT-A、NT-proBNP的曲线下面积（AUC）分别为0.803、0.715、0.692，三者联合检测的AUC为0.891，预测价值高于任一单一指标。结论CHF病人血清sST2、ACT-A、NT-proBNP的表达升高，并且三者的表达水平与NYHA分级呈明显正相关关系，与LVEF呈明显负相关关系，三者联合检测检测对CHF病人心血管事件具有较高的预测价值。
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| 关 键 词： | 心力衰竭 可溶性ST2 激活素A N-末端脑钠肽前体 |
| 收稿时间： | 2020-05-30 |
Clinical significance of the serum sST2, ACT-A and NT-proBNP in the occurrence and development of chronic heart failure |
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| Affiliation: | Department of Cardiology, Jinan People's Hospital, Jinan Shandong 271199, China |
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| Abstract: | ObjectiveTo investigate the serum levels of soluble ST2(sST2), activin A(ACT-A), and N-terminal brain natriuretic peptide precursor(NT-proBNP), and its clinical significance in the occurrence and development of chronic heart failure(CHF).MethodsA total of 149 patients with CHF and 50 healthy people were divided into the CHF group and control group, respectively.The differences of the serum levels of sST2, ACT-A, NT-proBNP between two groups, and correlation between three indicators and clinical parameters were analyzed.The ROC curves were used to analyze the predictive value of serum sST2, ACT-A and NT-proBNP in cardiovascular events of patients with CHF.ResultsCompared with the control group, the serum levels of sST2, ACT-A, NT-proBNP in patients with CHF were significantly higher(P < 0.01), while the Left Ventricular Ejection Fractions(LVEF) was significantly lower(P < 0.01).The serum levels of sST2, ACT-A, NT-proBNP in patients with NYHA grade Ⅳ were significantly higher than those in grade Ⅲ, and which in patients with grade Ⅲ was significantly higher than grade Ⅱ(P < 0.05).The serum levels of sST2, ACT-A, NT-proBNP in patients with CHF were significantly positively correlated with NYHA classification, and negatively correlated with LVEF(P < 0.05), but which were not related to the age, TC, TG, hsCRP, HDL-C, and LDL-C, hs-CRP and HbA1c(P>0.05).The ROC curve analysis results showed that the area under the curve(AUC) of sST2, ACT-A, and NT-proBNP was 0.803, 0.715, and 0.692, respectively.The combined detection AUC of all three was 0.891, and the predicted value of which was higher than that of any single indicator.ConclusionsThe serum levels of sST2, ACT-A, NT-proBNP in patients with CHF increase, and the expression levels of the three are significantly positively correlated with NYHA classification, and negatively correlated with LVEF.The combined detection in CHF patients has a high predictive value in cardiovascular events. |
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