儿茶酚抑素水平与慢性心力衰竭病人预后的相关性

目的:探讨儿茶酚抑素(CST)水平与慢性心力衰竭(CHF)病人预后之间的相关性.方法:选择CHF病人97例,入院时采集病人一般资料及相关临床数据,测定CST水平,选择同期体检健康成人50名作为对照,分析CHF病人CST水平与心功能分级、左心室射血分数(LVEF)之间的关系.所有CHF病人随访2年,绘制病人CST水平与2年内再发心力衰竭的ROC曲线;根据2年内是否发生心血管事件分为再发心血管事件组与非事件组,分析CHF病人再发心血管事件的危险因素.结果:CHF组病人CST水平显著高于对照组(P<0.01),CHF病人心功能分级与CST水平呈正相关关系(P<0.01),LVEF水平则与CST呈负相关关系(P<0.01).随访2年,失访5例,再发心力衰竭住院27例,病死4例,依据ROC曲线,以CST=0.75 ng/mL预测CHF病人再发心力衰竭的价值较高,敏感度为96.8%,特异度为85.2%;logistic回归分析显示,年龄增加、LVEF降低和CST升高均为CHF病人再发心血管事件的独立危险因素(P<0.05~P<0.01).结论:CST水平与CHF病人病情严重程度相关,检测CST对评估CHF病人预后有明确价值.

The correlation between the catestatin level and prognosis of patients with chronic heart failure

Objective:To explore the correlation between the catestatin(CST) level and prognosis of patients with chronic heart failure(CHF).Methods:The general information and associated clinical data of 97 patients with CHF were collected,and 50 healthy people were set as the control at the same time.The relationships between the CST level,heart function classification and left ventricular ejection fraction(LVEF) in CHF patients were analyzed.All patients were followed up for 2 years.The ROC curves of CST level and recurrence of cardiovascular event within 2 years were drew.The patients were divided into the recurrence of cardiovascular event group and non-event group according to the occurrence of the cardiovascular event.The risk factors of the occurrence of the cardiovascular event were analyzed in CHF patients.Results:The level of CST in CHF patients was significantly higher than that in healthy people(P<0.01).The heart function classification and LVEF level were positively and negatively related to the CST level in CHF patients,respectively(P<0.01).Within 2 years of the following up,miss following up in 5 cases,recurrence of heart failure and hospitalization in 27 cases,and death in 4 cases were identified.On the basis of the ROC curve,the value of CST level(0.75 ng/mL) in predicting the recurrence of the cardiovascular event was higher in CHF patients,the sensitivity and specificity of which were 96.8% and 85.2%,respectively.Logistic regression analysis showed that the age increasing,LVEF decreasing and CST increasing were the independent risk factor of the reoccurrence of cardiovascular events in patients with CHF(P<0.01 to P<0.05).Conclusions:The CST level is related to the severity of disease in CHF patients,which has definite value in evaluating the prognosis of patients with CHF.