摘要
目的探究血清和肽素、E选择素、胎盘生长因子、心功能与慢性收缩性心力衰竭患者预后的关系,为临床治疗慢性收缩性心力衰竭患者提供数据依据。方法选取某院2017年4月1日-2019年4月30日收治的慢性收缩性心力衰竭患者106例作为研究组,同期健康体检者106例作为健康对照组。比较研究组治疗前与健康对照组血清Copeptin、ES、PIGF水平。并将研究组根据是否发生主要不良心血管事件分为预后良好者76例、预后不良者30例,比较两组治疗前、治疗4周、8周后血清Copeptin、ES、PIGF水平及心功能指标,Pearson相关性分析各血清与心功能相关性,Logistic回归分析慢性收缩性心力衰竭预后影响因素,受试者工作特征曲线分析血清Copeptin、ES、PIGF对预后的预测价值。结果研究组治疗前血清Copeptin为(4.09±1.03)ng/L、ES为(87.10±19.15)μg/L、PIGF水平为(17.75±3.22)ng/L,均明显高于健康对照组的(1.27±0.28)ng/L、(53.47±10.36)μg/L、(8.43±1.34)ng/L,差异具有统计学意义,P<0.05;治疗4周、8周后预后良好者血清Copeptin、ES、PIGF水平低于预后不良者,LVEF、E/A高于预后不良者,差异具有统计学意义,P<0.05;治疗8周后,血清Copeptin、ES、PIGF与LVEF、E/A呈负相关;BMI、治疗4周后、治疗8周后血清Copeptin、ES、PIGF、LVEF、E/A是慢性收缩性心力衰竭预后的独立影响因素,差异具有统计学意义,P<0.05;预测预后指标敏感性由强到弱依次为:治疗8周后PIGF(AUC=0.798)、治疗8周后Copeptin(AUC=0.785)、治疗8周后ES(AUC=0.756)、治疗4周后PIGF(AUC=0.738)、治疗4周后ES(AUC=0.725)、治疗4周后Copeptin(AUC=0.716),具有统计学意义。结论血清Copeptin、ES、PIGF在慢性收缩性心力衰竭患者及预后不良患者中呈高表达,是影响心功能、预后的重要因素,并具有较高的预后预测价值,有望成为评估心功能、预后的生物标志物。
Objective To explore the relationship between serum,Copeptin,E-selectin(ES),placental growth factor(PIGF)and prognosis in patients with chronic systolic heart failure.Methods From April 1,2017 to April 30,2019,106 patients with chronic systolic heart failure admitted to our hospital were selected as the study group,and 106 healthy patients during the same period were selected as the healthy control group.The serum Copeptin,ES and PIGF levels of the study group before treatment and the healthy control group were compared.The study group was divided into those with good prognosis(not occurred,76 cases)and those with poor prognosis(occurred,30 cases)according to whether major adverse cardiovascular events(MACE)occurred.The serum Copeptin,ES,PIGF levels and cardiac function indexes level before,after four and eight weeks of treatment in the two groups were compared.Pearson correlation was used to analyze the correlation between each serum and heart function,and Logistic regression was used to analyze the factors affecting the prognosis of chronic systolic heart failure.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum Copeptin,ES and PIGF on prognosis.Results Serum Copeptin(4.09±1.03)ng/L,ES(87.10±19.15)μg/L and PIGF(17.75±3.22)ng/L levels in the study group before treatment were higher than those in the healthy control group(1.27±0.28)ng/L、(53.47±10.36)μg/L、(8.43±1.34)ng/L,(P<0.05).After four and eight weeks of treatment,serum Copeptin,ES,PIGF levels were lower than those with poor prognosis,and LVEF and E/A were higher than those with poor prognosis(P<0.05).After eight weeks of treatment,serum Copeptin,ES,PIGF were negatively correlated with LVEF and E/A(P<0.05).BMI,serum Copeptin,ES,PIGF,LVEF,and E/A at four weeks and eight weeks after treatment were independent factors influencing the prognosis of chronic systolic heart failure(P<0.05).AUC for predicting prognosis:PIGF(0.798)after eight weeks of treatment>Copeptin(0.785)after eight weeks of treatment>ES(0.756)after eight weeks of treatment>PIGF(0.738)after four weeks of treatment>ES(0.725)after four weeks of treatment>Copeptin(0.716)after four weeks of treatment(P<0.05).Conclusion Serum Copeptin,ES,and PIGF are highly expressed in patients with chronic systolic heart failure and patients with poor prognosis.They are important factors affecting heart function and prognosis,and have high prognostic value.They are expected to become biomarkers for evaluating cardiac function and prognosis.
作者
梁启权
谢志辉
曾胜宏
邓文森
Liang Qiquan;Xie Zhihui;Zeng Shenghong;Deng Wensheng(Yuedong Hospital,the Third Affiliated Hospital of Sun Yat sen University,Meizhou 514700,Guangdong Province,China;不详)
出处
《中国病案》
2021年第10期104-109,共6页
Chinese Medical Record
