摘要
目的探讨纤维化指标可溶性ST2(sST2)和半乳糖凝集素3水平对急性心力衰竭短期预后的评估价值。方法急性心力衰竭或慢性心力衰竭急性发作206例患者依据出院后随访90d终点事件(出院后90d内因心力衰竭急性发作再入院或死亡)分为发生事件组(A组,25例)和未发生事件组(B组,181例),ELISA法检测两组血清sST2和半乳糖凝集素3水平,全自动生化仪检测血浆N末端-B型脑利钠肽前体(NT-proBNP)水平。采用ROC曲线分析其评估急性心力衰竭患者短期预后的价值。结果 A组sST2和NT-proBNP水平高于B组(P<0.01)。两组半乳糖凝集素3水平无统计学差异(P>0.05)。取NT-proBNP 2622.00pg/ml为最佳临界值时,其预测的灵敏度为84.0%,特异度为71.8%;取sST2 49.82ng/ml为最佳临界值时,其预测的灵敏度为61.1%,特异度为82.1%。两者联合分析能提高NT-proBNP对患者短期预后的预测价值(P<0.01)。结论 sST2对急性心力衰竭患者短期预后有预测价值,联合分析能提高NT-proBNP对急性心力衰竭患者短期预后的预测价值。
Objective To explore the value of fibrosis-related indicators soluble ST2（sST2）and galectin 3 in predicting the short-term prognosis of patients with acute heart failure（AHF）.Methods According to the end events（readmission or death due to AHF or acute exacerbation of chronic heart failure）during follow-up for 90 days,a total of 206 patients was divided into two groups of A（with end events,25cases）and B（without end events,181cases）.Serum levels of sST2 and galectin 3 were detected by ELISA and plasma NT-proBNP level was detected with automatic biochemical analyzer.The values of them for predicting cardiovascular events in 90 days after discharge were analyzed by receiver-operating characteristic（ROC）curve.Results Serum levels of NT-proBNP and sST2 in group A were higher than those in group B（P〈0.01）,while galectin 3 levels were not significantly different between two groups（P〉0.05）.The area under ROC curve of NT-proBNP and sST2 for predicting cardiovascular events in 90 days after discharge were 0.806 and 0.756,respectively.Taking2622.00pg/ml as the cutoff value of NT-proBNP for predicting cardiovascular events in 90 days after discharge,the sencitivity and specificity were 84.0% and 71.8%.Taking 49.82ng/ml as the cutoff value of sST2,the sencitivity and specificity were 61.1% and 82.1%.Combined analysis of both improved the value of NT-proBNP in predicting the short-term prognosis of AHF patients（P〈0.01）.Conclusion Fibrosis-related indicator sST2 has a predictive value in evaluating the short-term prognosis of AHF patients,which can be improved when combined analysis of NT-proBNP and sST2.
出处
《江苏医药》
CAS
2016年第4期402-404,共3页
Jiangsu Medical Journal
基金
国家科技支撑计划课题(2011BAI11B08)
