摘要
目的探讨老年冠心病(coronary heart disease,CHD)合并衰弱综合征患者的血清Clara细胞分泌蛋白16(Clara cell secretory protein-16,CC16)、Klotho蛋白水平及其诊断价值。方法选取2021年8月至2023年6月温州老年病医院收治的295例CHD患者,根据患者有无衰弱综合征分为衰弱组和非衰弱组。ELISA法检测血清CC16、Klotho水平;Pearson法分析衰弱组患者的血清CC16、Klotho水平和炎症指标的相关性;采用Logistic分析老年CHD患者合并衰弱综合征的影响因素;受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析血清CC16、Klotho水平诊断老年CHD患者合并衰弱综合征的价值。结果与非衰弱组相比,衰弱组患者的血清CC16、Klotho水平明显降低(P<0.05),核因子-κB(nuclear factor kappa-B,NF-κB)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素(interleukin,IL)-6水平明显升高(P<0.05)。根据Pearson相关性显示,血清CC16与Klotho水平呈正相关(P<0.05),二者均与NF-κB、TNF-α、IL-6呈负相关(P<0.05)。轻、中和重度组患者的血清CC16、Klotho水平依次降低,NF-κB、TNF-α、IL-6水平依次升高(P<0.05)。根据Logistic分析显示,年龄、Charlson共病指数、肌少症、NF-κB、TNF-α、IL-6为老年CHD患者合并衰弱综合征的危险因素(P<0.05),血清CC16、Klotho水平为保护因素(P<0.05)。ROC曲线显示:血清CC16、Klotho水平单独及联合诊断老年CHD患者合并衰弱综合征的曲线下面积(area under curve,AUC)为0.839、0.819、0.907,联合诊断的AUC高于各自单独诊断(Z=2.715、Z=2.726,P<0.05)。结论老年CHD合并衰弱综合征患者的血清CC16、Klotho水平均降低,二者联合检测对CHD患者合并衰弱综合征有一定的诊断价值。
Objective To explore the levels and diagnostic value of serum Clara cell secretory protein-16(CC16)and Klotho in elderly patients with coronary heart disease(CHD)complicated with frailty syndrome.Methods From August 2021 to June 2023,295 CHD patients from Wenzhou Geriatric Hospital were selected and separated into frailty group and non-frailty group based on the presence or absence of frailty syndrome.ELISA was used to detect serum CC16 and Klotho levels.Pearson method was used to explore the correlation between serum CC16,Klotho levels,and inflammatory markers in frailty group.Logistic method was used to explore the influencing factors of frailty syndrome in elderly CHD patients.In addition,receiver operating characteristic(ROC)curve was used to analyze the value of serum CC16 and Klotho in diagnosing frailty syndrome in elderly CHD patients.Results Compared with non-frailty group,the patients of frailty group had clearly lower serum CC16 and Klotho(P<0.05),and clearly higher nuclear factor kappa-B(NF-κB),tumor necrosis factorα(TNF-α),and interleukin(IL)-6(P<0.05).According to Pearson correlation analysis,serum CC16 was positively correlated with Klotho(P<0.05),and both were negatively correlated with NF-κB,TNF-α,and IL-6(P<0.05).Serum CC16 and Klotho decreased sequentially in the mild,moderate,and severe groups,while NF-κB,TNF-α,and IL-6 increased sequentially(P<0.05).According to Logistic analysis,age,Charlson comorbidity index,sarcopenia,NF-κB,TNF-α,and IL-6 were risk factors for frailty syndrome in elderly CHD patients(P<0.05),while CC16 and Klotho were protective factors(P<0.05).ROC curve showed that the area under the curve(AUC)of serum CC16 and Klotho alone and their combination for diagnosing frailty syndrome in elderly CHD patients were 0.839,0.819,and 0.907,respectively.The AUC of combined diagnosis was higher than that of individual diagnosis(Z=2.715,Z=2.726,P<0.05).Conclusion Serum CC16 and Klotho are reduced in elderly patients with CHD complicated with frailty syndrome.The combined detection of the two has certain diagnostic value for patients with CHD complicated with frailty syndrome.
作者
汪聪玲
张胜靖
倪秀渊
周时更
WANG Congling;ZHANG Shengjing;NI Xiuyuan;ZHOU Shigeng(Department of Geriatric Medicine,Wenzhou Geriatric Hospital,Wenzhou 325000,Zhejiang,China;Department of Geriatric Medicine,Wenzhou Traditional Chinese Medicine Hospital,Wenzhou 325000,Zhejiang,China)
出处
《中国现代医生》
2026年第3期10-14,35,共6页
China Modern Doctor
基金
浙江省温州市医药卫生科技计划项目(2020010)。
