血清sST2和TN-C对慢性阻塞性肺疾病患者发生心血管事件的预测价值

The Value of Serum sST2 and TN-C in Predicting Cardiovascular Events in Patients with Chronic Obstructive Pulmonary Disease

目的探讨血清可溶性生长刺激基因表达蛋白2(sST2)和腱糖蛋白-C(TN-C)对慢性阻塞性肺疾病(COPD)患者发生心血管事件的预测价值。方法选择2019年1月—2020年5月该院收治的COPD患者84例。所有患者均定期复诊,随访1年,根据患者是否发生心血管事件分为发生组(n=24)与未发生组(n=60)。比较两组血脂、血压、肺功能指标[第1秒用力呼气容积(FEV1)/用力肺活量(FVC)、FEV1%pred]、超敏C反应蛋白(hs-CRP)以及TN-C、sST2水平;绘制受试者工作曲线(ROC)分析TN-C、sST2对COPD患者发生心血管事件的预测价值。结果两组血压、血脂指标比较,差异无统计学意义(P>0.05);发生组FEV1/FVC(54.79±8.21)%、FEV1%pred(58.69±10.37)%低于未发生组(66.34±11.57)、(69.12±13.45)%,hs-CRP (26.21±4.38)mg/L、TN-C (51.63±4.67)μg/L、sST2(60.54±7.65)μg/L高于未发生组(17.34±3.97)mg/L、(37.12±3.89)μg/L、(44.25±4.07)μg/L,差异有统计学意义(t=4.455、3.411、8.981、14.569、12.671,P<0.001)。绘制ROC曲线结果显示,TN-C、sST2预测COPD发生心血管事件的AUC为0.745(0.679~0.877)、0.809(0.711~0.918),预测价值均较高。结论 COPD发生心血管事件患者TN-C、sST2水平均出现异常升高,对预测心血管事件发生有较高的应用价值。

Objective To explore the predictive value of serum soluble growth-stimulating gene expression protein 2(sST2) and tenascin-C(TN-C) in the occurrence of cardiovascular events in patients with chronic obstructive pulmonary disease(COPD). Methods A total of 84 COPD patients admitted to the hospital from January 2019 to May 2020 were selected. All patients were reviewed regularly and followed up for 1 year. According to whether the patients had a cardiovascular event, they were divided into the occurrence group(n=24) and the non-occurring group(n=60).Compared the two groups of blood lipids, blood pressure, lung function indicators [forced expiratory volume in the first second(FEV1)/forced vital capacity(FVC), FEV1%pred], high-sensitivity C-reactive protein(hs-CRP), and TN-C and sST2 levels. Draw receiver operating curve(ROC) to analyze the predictive value of TN-C and sST2 for cardiovascular events in COPD patients. Results There was no significant difference in blood pressure and blood lipid indexes between the two groups(P>0.05). FEV1/FVC(54.79±8.21)%, FEV1%pred(58.69±10.37)% in the occurrence group were lower than(66.34±11.57),(69.12±13.45)% in the non-occurring group, hs-CRP(26.21±4.38) mg/L, TN-C(51.63±4.67) μg/L,sST2(60.54±7.65) μg/L, higher than the non-occurring group(17.34±3.97) mg/L,(37.12±3.89) μg/L,(44.25±4.07) μg/L,the difference was statistically significant(t=4.455, 3.411, 8.981, 14.569, 12.671, P<0.001). The results of drawing the ROC curve showed that the AUC of TN-C and s ST2 for predicting cardiovascular events in COPD were 0.745(0.679~0.877) and 0.809(0.711~0.918), both of which had high predictive value. Conclusion The TN-C and sST2 levels of patients with cardiovascular events in COPD have abnormally increased, which has a high application value in predicting the occurrence of cardiovascular events.