摘要
目的 探讨血清补体C1q/肿瘤坏死因子相关蛋白3(CTRP3)、波形蛋白(VTN)水平与扩张型心肌病慢性心力衰竭患者预后的关系。方法 选取2021年1月至2022年8月河北省邢台市中心医院收治的扩张型心肌病慢性心力衰竭患者179例,根据1年预后分为预后不良组(63例)和预后良好组(116例)。采用酶联免疫吸附试验检测血清CTRP3、VTN水平。单因素和多因素logistic回归分析影响扩张型心肌病慢性心力衰竭患者预后的因素,受试者操作特征曲线分析血清CTRP3、VTN水平对扩张型心肌病慢性心力衰竭患者预后不良的预测价值。结果 随访1年,179例扩张型心肌病慢性心力衰竭患者预后不良发生率为35.20%(63/179)。两组年龄、慢性心力衰竭病程、心功能分级、左室射血分数(LVEF)、CTRP3、VTN比较,差异有统计学意义(P<0.05)。两组性别、吸烟史、饮酒史、合并疾病、收缩压、舒张压、治疗药物、器械辅助治疗比较,差异无统计学意义(P>0.05)。年龄增加[OR(95%CI):1.090(1.007~1.179)]、心功能分级增加[OR(95%CI):3.868(1.405~10.652)]、VTN升高[OR(95%CI):1.101(1.039~1.167)],LVEF增加[OR(95%CI):0.680(0.543~0.850)]和CTRP3升高[OR(95%CI):0.946(0.916~0.978)]为扩张型心肌病慢性心力衰竭患者预后不良的影响因素(P<0.05)。血清CTRP3联合VTN水平预测扩张型心肌病慢性心力衰竭患者预后不良的曲线下面积(0.878)大于血清CTRP3、VTN水平单独预测的0.782、0.787(Z=3.779、3.546,P<0.05)。结论 扩张型心肌病慢性心力衰竭患者血清CTRP3水平降低、VTN水平升高与预后不良密切相关,二者联合预测扩张型心肌病慢性心力衰竭患者预后不良的价值较高。
Objective To investigate the relationship between serum complement C1q/tumor necrosis factor-related protein 3(CTRP3)and vimentin(VTN)levels and prognosis in chronic heart failure patients with dilated cardiomyopathy.Methods A total of 179 patients with dilated cardiomyopathy chronic heart failure admitted to Xingtai Central Hospital,Hebei Province from January 2021 to August 2022 were selected and they were divided into poor prognosis group(63 cases)and good prognosis group(116 cases)according to one-year prognosis.Serum CTRP3 and VTN levels were detected by enzyme linked immunosorbent assay.Univariate and multivariate logistic regression analysis were conducted to analyze the prognostic factors of dilated cardiomyopathy chronic heart failure,and the predictive value of serum CTRP3 and VTN levels on poor prognosis of patients with dilated cardiomyopathy chronic heart failure was analyzed by receiver operator characteristic curve.Results After one year follow-up,the incidence of poor prognosis in 179 patients with dilated cardiomyopathy chronic heart failure was 35.20%(63/179).There were significant differences in age,duration of chronic heart failure,cardiac function grade,left ventricular ejection fraction(LVEF),CTRP3,and VTN between the two groups(P<0.05).There were no significant differences in gender,smoking history,drinking history,combined diseases,systolic blood pressure,diastolic blood pressure,therapeutic drugs,and instrument-assisted treatment between the two groups(P>0.05).Age increased(OR[95%CI]:1.090[1.007-1.179]),cardiac function grade increased(OR[95%CI]:3.868[1.405-10.652]),VTN increased(OR[95%CI]:1.101[1.039-1.167]),LVEF increased(OR[95%CI]:0.680[0.543-0.850])and CTRP3 increased(OR[95%CI]:0.946[0.916-0.978])were influential factors for poor prognosis in patients with dilated cardiomyopathy chronic heart failure(P<0.05).The area under the curve of CTRP3 combined with VTN in predicting poor prognosis of patients with chronic heart failure in dilated cardiomyopathy(0.878)was greater than 0.782 and 0.787 predicted by CTRP3 and VTN alone(Z=3.779,3.546,P<0.05).Conclusion The decrease of serum CTRP3 level and the increase of VTN level are closely related to poor prognosis in patients with dilated cardiomyopathy chronic heart failure.The combined value of CTRP3 and VTN is higher in predicting poor prognosis of chronic heart failure of dilated cardiomyopathy.
作者
周松
郝清卿
黄玲芳
达迎晓
崔振川
狄宁宁
ZHOU Song;HAO Qingqing;HUANG Lingfang;DA Yingxiao;CUI Zhenchuan;DI Ningning(Ward Two,Department of Cardiology,Xingtai Central Hospital,Hebei Province,Xingtai 054000,China;the First Department of Cardiology,Hebei General Hospital,Hebei Province,Shijiazhuang 050000,China)
出处
《中国医药导报》
CAS
2024年第17期54-57,69,共5页
China Medical Herald
基金
河北省“三三三人才工程”资助项目(A202101065)
河北省邢台市重点研发计划项目(2023ZC098)。
