血清sST2、H-FABP及Hcy对心力衰竭患者预后的预测价值

The value of serum sST2,H-FABP and Hcy on prognosis in patients with heart failure

目的:探讨血清可溶性基质裂解素2(sST2)、心型脂肪酸结合蛋白(H-FABP)及同型半胱氨酸(Hcy)对心力衰竭(HF)患者预后的预测价值。方法:选取本院收治的HF患者130例,根据随访1年内是否发生不良事件分为预后良好组和不良预后组。比较两组患者基础资料及血清sST2、H-FABP、Hcy水平差异,绘制受试者工作特征曲线(ROC)分析血清sST2、H-FABP、Hcy对HF预后的预测价值。结果:随访期间130例HF患者中39例出现不良事件,发生率为30.00%。预后不良组中心功能分级Ⅲ-Ⅳ级患者比例和LVEDD均明显高于预后良好组,LVEF则显著低于预后良好组。预后不良组患者血清sST2、H-FABP及Hcy水平高于预后良好组。HF患者血清sST2、H-FABP、Hcy水平与心功能分级及LVEDD呈正相关,而与LVEF呈负相关。Logistic回归分析,NYHA分级、LVEF、LVEDD及血清sST2、H-FABP、Hcy水平是影响HF患者预后的重要危险因素。sST2、H-FABP、Hcy联合检测对预后不良预测的曲线下面积为0.968,且联合检测诊断特异度显著高于单独检测。结论:血清sST2、H-FABP、Hcy水平与HF患者心功能状况有关,可作为评估患者预后的参考指标。

Objective To investigate the value of serum sST2,H-FABP and Hcy on prognosis in patients with heart failure(HF).Methods 130 HF patients admitted to our hospital were selected and divided into good prognosis group with and poor prognosis group according to whether adverse events occurred within 1 year of follow-up.The basic data and serum sST2,H-FABP,Hcy levels of the two groups were compared,and the receiver operating Characteristic curve(ROC)was drawn to analyze the predictive value of serum sST2,H-FABP,and Hcy in HF prognosis.Results During follow-up,adverse events occurred in 39 of 130 HF patients,with an incidence of 30.00%.The proportion of NYHA classⅢ-Ⅳand LVEDD in poor prognosis group were significantly higher than that of good prognosis group,while the LVEF was significantly lower than good prognosis group.The levels of sST2,H-FABP and Hcy in the poor prognosis group were also higher than those in the good prognosis group.Serum sST2,H-FABP,Hcy levels in HF patients were positively correlated with cardiac function grading and LVEDD,while negatively correlated with LVEF.Logistic regression analysis showed that NYHA classification,LVEF,LVEDD,serum sST2,H-FABP,and Hcy levels were important risk factors affecting the prognosis of HF patients.The area under the curve of combined detection for the prediction of poor prognosis was 0.968.The diagnostic specificity of the combined test was significantly higher than that of the single test.Conclusion Serum sST2,H-FABP,and Hcy levels are related to cardiac function in HF patients,and can be used as reference indicators to evaluate the prognosis of patients.