血清TSG-6、FGF23水平对慢性心力衰竭患者预后的预测价值

The prognostic value of serum TSG-6and FGF23levels in patients with chronic heart failure

目的探讨血清肿瘤坏死因子α刺激基因-6(TSG-6)、成纤维细胞生长因子23(FGF23)水平对慢性心力衰竭(CHF)患者预后的预测价值。方法选取CHF患者104例及健康体检者60名(对照组)。采用酶联免疫吸附法进行血清TSG-6和FGF23的检测。分析血清TSG-6和FGF23水平与患者心功能分级的相关性,采用logistic回归模型分析CHF患者预后不良的影响因素,并采用受试者工作特征(ROC)曲线评价TSG-6和FGF23的预后预测价值。结果相比对照组,CHF患者血清TSG-6、FGF23水平显著增高(P<0.05)。随着心功能分级的提高,患者血清TSG-6、FGF23水平逐渐增高(P<0.05);Spearman相关分析显示,血清TSG-6、FGF23水平与心功能分级均呈正相关(P<0.05)。Logistic回归分析表明,心功能分级≥Ⅲ级、血清TSG-6和FGF23水平是CHF患者预后不良的危险因素(P<0.05)。绘制血清TSG-6、FGF23预测CHF患者预后不良的ROC曲线显示,二者AUC分别为0.730、0.685,二者联合的AUC为0.828,相比单一指标显著提高(P<0.05)。结论CHF患者血清TSG-6、FGF23水平显著增高,TSG-6、FGF23可作为CHF病情和预后评估指标。

Objective To investigate the prognostic value of serum tumor necrosis factor α-stimulated gene-6(TSG-6)and fibroblast growth factor 23(FGF23)levels in patients with chronic heart failure(CHF).Methods 104 patients with CHF and 60healthy subjects(control group)were selected.Serum TSG-6 and FGF23 were detected by enzymelinked immunosorbent assay.The correlation between serum TSG-6 and FGF23 levels and cardiac function classification was analyzed.Logistic regression model was used to analyze the influencing factors of poor prognosis in CHF patients,and the prognostic predictive value of TSG-6 and FGF23 was evaluated by receiver operating characteristic(ROC)curve.Results Compared with the control group,the serum levels of TSG-6 and FGF23 in CHF patients were significantly higher(P<0.05).With the improvement of cardiac function classification,the serum levels of TSG-6 and FGF23 gradually increased(P<0.05).Spearman correlation analysis showed that serum TSG-6 and FGF23 levels were positively correlated with cardiac function classification(P<0.05).Logistic regression analysis showed that cardiac function grade≥Ⅲ,serum TSG-6 and FGF23 levels were risk factors for poor prognosis in CHF patients(P<0.05).The ROC curve of serum TSG-6 and FGF23 in predicting poor prognosis of CHF patients showed that the AUC of the two was 0.730 and 0.685,respectively,and the AUC of the combination of the two was 0.828,which was significantly higher than that of the single index(P<0.05).Conclusion The serum levels of TSG-6and FGF23 in patients with CHF are significantly increased,and TSG-6 and FGF23 can be used as indicators for evaluating the condition and prognosis of CHF.