可溶性ST2及NT-proBNP在心力衰竭中的变化和临床意义

Change and clinical significance of soluble ST2 and NT-pro BNP in heart failure

目的观察心力衰竭中可溶性ST2（s ST2）与NT-pro BNP的变化及对短期预后的评估价值。方法选取2012年10月-2014年8月本院收治入院的心力衰竭住院患者52例为病例组,另选取本院同期健康体检者52例作为健康对照组,采用酶联免疫吸附法测定患者入院时血浆s ST2水平,采用胶体金法检测NT-pro BNP水平,并比较两个指标在不同心功能级别患者之间的水平差异。结果按NYHA心功能分级,随着分级增高,s ST2、NT-pro BNP测定值增高,LVEF降低,差异有统计学意义（P〈0.05）;病例组患者s ST2、NT-pro BNP水平明显高于健康对照组,差异有统计学意义（P〈0.05）;病例组患者LVEF水平明显低于健康对照组,差异有统计学意义（P〈0.05）;s ST2、NT-pro BNP与LVEF呈负相关（P〈0.01）,与NYHA心功能分级呈明显正相关（P〈0.01）。Logistic回归分析发现,NT-pro BNP、s ST2是心力衰竭短期预后的独立预测因子（P〈0.01）。结论 s ST2和NT-pro BNP水平检测可能对不同程度心力衰竭的鉴别诊断及短期预后的评估具有一定的临床意义。

Objective To observe the change of soluble ST2（s ST2）and NT-pro BNP in heart failure and estimated value of short-term prognosis. Methods 52 patients with heart failure admitted into our hospital from October 2012 to August2014 were selected as diseased group.Another 52 participants for healthy physical examinations in the same period were classified into healthy control group.The level of plasma s ST2 on admission was measured by enzyme linked immunosorbent assay（ELISA）,and the level of NT-pro BNP was tested colloidal gold method.The differences of two indexes were compared in different levels of cardiac function. Results According to New York Heart Association（NYHA）grading,the higher the grading was,the higher the measured values of s ST2 and NT-pro BNP were,the higher the grading was,the lower the measured value of LVEF was,which displayed statistical difference（P 0.05）.The level of s ST2 and NT-pro BNP in diseased group was obviously higher than that in healthy control group respectively,with statistical difference（P〈0.05）.The level of LVEF in diseased group was much lower than that in healthy control group,with a statistical difference（P〈0.05）.Two markers of s ST2 and NT-pro BNP had negative correlations with LVEF（P〈0.01）,but indicated statistically positive correlation with NYHA grading（P〈0.01）.Logistic regression analysis showed that NT-pro BNP and ST2 were two independent predictive factors in short-term prognosis of heart failure（P〈0.01）. Conclusion Test of s ST2 and NT-pro BNP level may have some clinical significance in differential diagnosis and short-term prognosis evaluation of heart failure in different degree.