摘要
目的探讨血清心型脂肪酸结合蛋白(H-FABP)、生长分化因子-15(GDF-15)及核因子κB(NF-κB)水平与慢性心力衰竭(CHF)患者病情及预后的关系。方法将98例CHF患者根据1年内预后情况分为不良预后组(33例)和预后良好组(65例)。根据纽约心脏病协会(NYHA)对CHF进行分级,对比不同心功能分级和不同预后患者血清H-FABP、GDF-15及NF-κB水平差异。Logistic回归法分析各研究指标与患者预后的关系,绘制受试者工作曲线(ROC)分析血清H-FABP、GDF-15及NF-κB对CHF预后的评估效能。结果 NYHA分级Ⅱ级患者血清H-FABP、GDF-15及NF-κB水平显著低于Ⅲ级患者,差异有统计学意义(P<0.05);不良预后组患者血清H-FABP、GDF-15及NF-κB水平高于预后良好组,差异有统计学意义(P<0.05)。Logistic回归分析显示,心功能分级、血清H-FABP、GDF-15及NF-κB水平是影响CHF患者预后的独立因素。H-FABP、GDF-15及NF-κB检测评估慢性心力衰竭的AUC分别为0.850、0.817、0.873,三项指标联合检测对CHF患者预后评估的AUC和灵敏度均高于单独检测(P<0.05)。结论血清H-FABP、GDF-15及NF-κB水平随CHF患者心功能分级加重而升高,H-FABP、GDF-15及NF-κB联合检测有助于CHF患者短期预后风险的预测。
Objective To investigate the correlations between serum heart-type fatty acid binding protein(H-FABP),growth differentiation factor-15(GDF-15) and nuclear factor κB(NF-κB) with severity and prognosis of patients with chronic heart failure(CHF).Methods 98 patients with CHF were divided into poor prognosis group(33 cases) and good prognosis group(65 cases) according to the prognosis within one year.Differences of H-FABP,GDF-15 and NF-κB levels were compared in patients with different heart function grades and different prognosis.Logistic regression was used to analyze the relationship between each index and prognosis.The receiver operating characteristic curve(ROC) was designed to analyze the efficacy of serum H-FABP,GDF-15 and NF-κB in evaluating the prognosis of CHF.Results The serum levels of H-FABP,GDF-15 and NF-κB in patients with NYHA grade Ⅱ were significantly lower than those of grade Ⅲ(P<0.05).The levels of H-FABP,GDF-15 and NF-κB in poor prognosis group were higher than those in good prognosis group(P<0.05).Logistic regression analysis showed that heart function grade,serum H-FABP,GDF-15 and NF-κB were independent factors affecting the prognosis of CHF.The AUCs of H-FABP,GDF-15 and NF-κB were 0.850,0.817 and 0.873,respectively.The prognostic AUC and sensitivity of combined indexes were all higher than single index(P<0.05).Conclusion The levels of H-FABP,GDF-15 and NF-κB were increased with the aggravation of heart function grade in patients with CHF.The combined detection of H-FABP,GDF-15 and NF-κB should be helpful to predict the short-term prognostic risk of CHF.
作者
肖光明
XIAO Guang-ming(Department of Cardiology,First People′s Hospital of Xiaogan city,Xiaogan,Hubei 432000,China)
出处
《热带医学杂志》
CAS
2020年第8期1065-1069,共5页
Journal of Tropical Medicine
