摘要
目的探讨心力衰竭(HF)患者外周血可溶性生长刺激表达基因2蛋白(sST2)、单核细胞/高密度脂蛋白胆固醇比值(MHR)、同型半胱氨酸(Hcy)与射血分数(LVEF)的相关性,并分析其对预后不良的预测价值。方法选取2023年1月至2024年1月该院收治的100例HF患者作为研究对象,根据美国纽约心脏病学会(NYHA)分级分为NYHAⅠ级组21例、NYHAⅡ级组29例、NYHAⅢ级组40例、NYHAⅣ级组10例。比较不同NYHA分级HF患者血清sST2、MHR、Hcy水平及心功能指标[LVEF、左心室舒张末期内径(LVEDD)];采用Pearson相关分析血清sST2、MHR、Hcy与LVEF、LVEDD的相关性。随访6个月,根据HF患者是否发生不良预后事件(再发HF入院、心血管不良事件、全因死亡)分为预后良好组、预后不良组。比较不同预后HF患者血清sST2、MHR、Hcy水平,分析三者对HF患者预后不良的预测价值。结果不同NYHA分级患者血清sST2、MHR、Hcy及LVEF、LVEDD比较,差异均有统计学意义(P<0.05)。血清sST2、Hcy水平及MHR与LVEF呈负相关(P<0.05),与LVEDD均呈正相关(P<0.05)。预后良好组72例,预后不良组28例。预后良好组入院24、72 h血清sST2、Hcy水平及MHR均低于预后不良组(P<0.05),ΔsST2、ΔMHR、ΔHcy均大于预后不良组(P<0.05)。入院24 h sST2、入院72 h sST2、ΔsST2、入院24 h MHR、入院72 h MHR、ΔMHR、入院24 h Hcy、入院72 h Hcy、ΔHcy预测HF患者预后不良的曲线下面积(AUC)分别为0.765、0.805、0.821、0.749、0.769、0.803、0.756、0.826、0.739。结论HF患者血清sST2、MHR、Hcy与LVEF密切相关,对预后不良有较高预测价值,可作为HF临床治疗、病情及预后评估的有效血清学指标。
Objective To investigate the correlation between peripheral blood soluble suppression of tumorigenicity 2 protein(sST2),monocyte to high-density lipoprotein cholesterol ratio(MHR),homocysteine(Hcy)and left ventricular ejection fraction(LVEF)in patients with heart failure(HF),and to analyze their predictive value for poor prognosis.Methods A total of 100 HF patients admitted to the hospital from January 2023 to January 2024 were selected as research subjects.According to the New York Heart Association(NYHA)functional classification,there were 21 cases in the NYHA classⅠgroup,29 cases in the NYHA classⅡgroup,40 cases in the NYHA classⅢgroup,and 10 cases in the NYHA classⅣgroup.The serum levels of sST2,MHR and Hcy,as well as cardiac function indicators[LVEF,left ventricular end-diastolic diameter(LVEDD)]were compared among HF patients classified by different NYHA functional classes.The correlation between serum sST2,MHR,Hcy levels and LVEF,LVEDD was analyzed.After a 6-month follow-up,the patients were divided into the good prognosis group and poor prognosis group based on the occurrence of adverse outcomes(recurrent HF hospitalization,cardiovascular events and all-cause mortality).The serum levels of sST2,MHR and Hcy were compared between the two prognosis groups,and their predictive value for poor prognosis of HF patients were analyzed.Results There were statistically significant differences in serum sST2,MHR,Hcy,LVEF and LVEDD among HF patients with varying NYHA classifications(P<0.05).Serum levels of sST2,Hcy and MHR were negatively correlated with LVEF(P<0.05)and positively correlated with LVEDD(P<0.05).A total of 72 patients were in the good prognosis group,while 28 patients were in the poor prognosis group.Serum levels of sST2,Hcy and MHR at 24 h and 72 h after admission were significantly lower in the good prognosis group compared with the poor prognosis group(P<0.05).The changes in sST2,MHR,and Hcy(ΔsST2,ΔMHR andΔHcy)were significantly greater in the good prognosis group than those in the poor prognosis group(P<0.05).The areas under the curve(AUC)for predicting poor prognosis in HF patients using serum levels of sST2 at 24 h,sST2 at 72 h,ΔsST2,MHR at 24 h,MHR at 72 h,ΔMHR,Hcy at 24 h,Hcy at 72 h,andΔHcy were 0.765,0.805,0.821,0.749,0.769,0.803,0.756,0.826 and 0.739 respectively.Conclusion Serum levels of sST2,MHR and Hcy in patients with HF are closely associated with LVEF and have high predictive value for poor prognosis.They can serve as effective serological markers for clinical treatment,disease assessment and prognosis evaluation in HF patients.
作者
高宇婷
陶杰
秦露
刘锦梅
GAO Yuting;TAO Jie;QIN Lu;LIU Jinmei(Department of Medical Laboratory,the First Central Hospital of Baoding,Baoding,Hebei 071000,China;Department of Cardiology,the First Central Hospital of Baoding,Baoding,Hebei 071000,China)
出处
《检验医学与临床》
2025年第11期1534-1539,共6页
Laboratory Medicine and Clinic
基金
河北省保定市社发类项目(2241ZF249)。
