可溶性ST2在心血管疾病中的临床应用及展望

Soluble ST2 and its prospects of clinical application in cardiovascular disease

可溶性ST2（sST2）是白细胞介素-33（IL-33）的可溶性受体。当心肌细胞受到生物机械性拉伸时sST2和跨膜型ST2（ST2L）表达明显增高，尤其是sST2表达更为明显。大量sST2与IL-33结合，从而阻断IL-33与ST2L结合，继而削弱IL-33／ST2L信号通路的心血管保护作用。近年研究显示，sST2有望作为一种新的心力衰竭标志物应用于临床。血浆sST2对心力衰竭的诊断价值不及NT—proBNP，但可较好地预测呼吸困难、急性或慢性心力衰竭、心肌梗死患者的预后，尤其是中长期（1年及1年以上）预后。但是，需要更多的循证医学证据以证实血浆sST2对心血管疾病患者心力衰竭风险评估及预后的临床价值。（中华检验医学杂志，2014，37：969-972）

Soluble ST2 （sST2） is a decoy receptor of IL-33 in blood, sST2and ST2L （receptor on cell membrane） seem to be markedly induced in mechanically overloaded cardiac myocytes, especially the expression of sST2. A large number of sST2 bind IL-33 thus subtracting IL-33 from the interaction with ST2L, potentially attenuating the cardioprotective effects of IL-33/ST2L pathway. Recently, sST2 has emerged as a novel for heart failure biomarker. Though sST2 was a less robust marker for the diagnosis of heart failure than NT-proBNP, it has been implicated in the prognostication of patients with acute dyspnea, acute or chronic heart failure and myocardial infarction, with particular value for mid- and long-term prognosis. However, further studies are needed in order to better point out the evidence for a routine use of sST2 evaluation in patients suffering from cardiovascular diseases. （Chin J Lab Med,2014 ,37 ：969-972 ）