慢性心力衰竭患者血清sST2、Galectin-3水平变化及临床意义

目的探究慢性心力衰竭(心衰)患者血清可溶性肿瘤因子2抑制剂(sST2)、半乳糖凝集素-3(galectin-3)水平变化及临床意义。方法选取2016年4月至2018年4月期间收治于广州市第十二人民医院心血管内科诊断为慢性心衰患者83例(慢性心衰组),同期随机选取45例健康受试者作为对照组。测定左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)及左室射血分数(LVEF)水平。采用酶联免疫吸附法(ELISA)检测血清sST2、galectin-3水平。记录随访6个月后心血管事件的发生情况,绘制两指标的ROC曲线。结果慢性心衰患者的LVESD、LVEDD值高于对照组(P<0.05),且心功能分级越高,LVESD、LVEDD值越高(P<0.05);而LVEF低于对照组,且心功能分级越高,LVEF值越低(P<0.05)。慢性心衰患者血清中sST2、galectin-3水平高于对照组,随着心功能的升高,血清sST2、galectin-3水平随之升高(P<0.05)。Pearson相关性分析显示慢性心衰患者血清sST2和galectin-3均与LVESD、LVEDD成正相关(P<0.05),与LVEF成负相关(P<0.05)。ROC曲线预测不良心血管事件结果显示,sST2曲线下面积(AUC)为0.752(95%CI:0.669~0.835),最佳临界值为12.89 ng/ml,其预测的灵敏度为62.7%,特异度为84.6%;galectin-3的AUC为0.961(95%CI:0.931~0.991),最佳临界值为15.94 ng/ml,其预测的灵敏度为88.0%,特异度为80.6%。结论慢性心衰患者血清sST2、galectin-3水平上升,与NYHA心功能分级及心功能密切相关,检测sST2、galectin-3水平可预测预后。

Changes and clinical significance of serum sST2 and galectin-3 levels in patients with chronic heart failure

Objective To study the changes and clinical significance of levels of soluble suppression of tumorigenicity 2(sST2)and galectin-3(Gal-3)in patients with chronic heart failure(CHF).Methods CHF patients(n=83)were chosen into CHF group,and healthy controls(n=45)were chosen into control group from the Twelfth People’s Hospital of Guangzhou City from Apr.2016 to Apr.2018.The levels of left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic inner diameter(LVEDD)and left ventricular ejection fraction(LVEF)were detected.The levels of serum sST2 and Gal-3 were detected by using enzyme-linked immunosorbent assay(ELISA).The occurrence of cardiovascular events was recorded after followed up for 6 months,and receiver operating characteristic(ROC)curves of sST2 and Gal-3 were drawn.Results The levels of LVESD and LVEDD were higher in CHF group than those in control group(P<0.05),and the higher the NYHA classification,the higher the levels of LVESD and LVEDD(P<0.05).The level of LVEF was lower in CHF group than that in control group,and the lower the NYHA classification,the lower of LVEF level(P<0.05).The levels of serum sST2 and Gal-3 were higher in CHF group than those in control group,and increased with NYHA classification increased(P<0.05).The results of Pearson correlation analysis showed that the levels of serum sST2 and Gal-3 were positively correlated to LVESD and LVEDD(P<0.05),and negatively correlated to LVEF(P<0.05).The results of ROC curves for predicting adverse cardiovascular events showed that the AUC of sST2 was 0.752(95%CI:0.669~0.835),the optimum critical value was 12.89 ng/ml,sensitivity was 62.7% and specificity was 84.6%,and the AUC of Gal-3 was 0.961(95%CI:0.931~0.991),the optimum critical value was 15.94 ng/ml,sensitivity was 88.0% and specificity was 80.6%.Conclusion The increases of levels of serum sST2 and Gal-3 are closely correlated to NYHA classification and heart function,so level detections of serum sST2 and Gal-3 can predict the prognosis in CHF patients.