可溶性人基质裂解素2在慢性心力衰竭诊断和预后中的临床研究

目的探讨血清可溶性人基质裂解素2(sST2)与慢性心力衰竭(CHF)的关系,及其对CHF诊断和预后的临床价值。方法选取60例CHF患者和60例非CHF患者分别作为CHF组和对照组,并依据诊断临界值将CHF组分为sST2低水平组和sST2高水平组,采用ELISA法检测各组血清sST2水平,并对CHF组进行6个月随访,观察血清sST2对CHF预后生存率的影响。结果 CHF组与对照组在年龄、性别、体质量指数、基本病史、基本用药情况和血脂指标等方面差异无统计学意义(P0.05),CHF组血清脑钠肽(BNP)水平明显高于对照组(P0.01)。CHF组与对照组血清sST2水平分别为(55.08±3.98)、(10.46±0.72)ng/mL,差异有统计学意义(P0.01)。血清sST2与BNP呈正相关(r=0.460 6,P0.01),且95%CI为0.306 6~0.591 1。以0.530 3为临界值时,血清sST2联合BNP检测的曲线下面积、95%CI、灵敏度、特异度和阳性似然比分别为0.936 2、0.885 3~0.987 7、85.00%(73.43%~92.90%)、98.33%(91.06%~99.96%)、50.00。Low组与High组生存曲线比较差异有统计学意义(P=0.014 9)。结论血清sST2可作为CHF诊断和预后评估的新型生物标志物,而且与血清BNP联合可能有更好的诊断价值。

Clinical research on soluble human matrix lysine 2 in diagnosis and prognosis of chronic heart failure

Objective To explore the relationship between serum soluble human matrix lysine 2 (sST2) with chronic heart failure(CHF) and its clinical value for diagnosis and prognosis of CHF .Methods 60 cases of CHF and 60 cases of non-CHF were selected as the CHF group and control group respectively ,and the CHF group was divided into sST2 low level group and sST2 high level group according to the diagnostic threshold .The ELISA method was used to detect the serum sST 2 level of each group .The CHF group were followed up for 6 months .Then the influence of sST2 on CHF prognosis survival rate was observed .Results There was no statistical difference in age ,gender ,body mass index ,basic disease history ,basic medication situation and blood lipid indexes between the CHF group and control group(P＞0 .05);serum brain natriuretic peptide(BNP) level in the CHF group was obviously higher than that in the control group(P＜0 .01);serum sST2 levels in the CHF group and control group were (55 .08 ± 3 .98)ng/mL and (10 .46 ± 0 .72)ng/mL ,the difference was statistically significant (P＜0 .01) .Serum sST2 was positively correlated with BNP(r=0 .4606 ,P＜0 .01) ,moreover 95% CI was 0 .3066-0 .5911 .When the critical value was 0 .5303 ,the area under curve ,95% CI ,sensitivity ,specificity and likelihood ratio of sST 2 combined BNP detection were 0 .9362 ,0 .8853 -0 .9877 , 85 .00% (73 .43% -92 .90% ) ,98 .33% (91 .06% -99 .96% ) and 50 .00 respectively .The survival curve had statistical difference between the sST2 low level group and sST2 high level group(P=0 .0149) .Conclusion Serum sST2 can be used as a new biomarker for the diagnosis and prognosis of CHF ,and its combined with BNP may have better diagnostic value.