扩张性心肌病患者生长抑素受体2表达变化及诊断意义

Expression change of serum somatostatin receptor 2 and its diagnostic significance in patients with dilated cardiomyopathy

目的探讨扩张性心肌病(DCM)患者血清生长抑素受体2(SSTR2)水平及其临床意义。方法采用酶联免疫双抗夹心法对2010年6月至2013年6月就诊的52例DCM患者和同期60例对照者外周血中SSTR2水平进行检测,同时检测两组血清中脑钠肽(BNP)水平,并结合研究对象一般临床资料、超声心动图、其他血清学指标进行综合分析。绘制受试者工作特征(ROC)曲线,评价SSTR2对DCM的诊断价值。结果心功能分级为Ⅲ-Ⅳ级的DCM患者,血清SSTR2与BNP水平均显著高于对照组,差异有统计学意义(P<0.05),但是对于心功能Ⅱ级的患者,仅SSTR2水平高于对照组,差异有统计学意义(P<0.05)。相关分析结果表明,Ⅲ-Ⅳ级患者SSTR2、BNP水平与左心室射血分数(LVEF)均呈负相关关系(r=-0.53、-0.43,P<0.05),但是Ⅱ级患者仅SSTR2与LVEF呈负相关(r=-0.45,P<0.05)。ROC曲线显示,对于Ⅱ级患者,SSTR2的诊断曲线下面积为0.702,明显优于BNP的诊断曲线下面积(0.573)。结论 DCM患者血清SSTR2水平增高,与患者心肌纤维化、心肌细胞肥大和心力衰竭有密切关系。尤其是心功能Ⅱ级的DCM患者,SSTR2相对于BNP,灵敏度更高,能及时反映DCM患者早期心功能不全,是一项具有潜力的生物学指标。

Objective To investigate the level of serum somatostatin receptor 2（SSTR2） in dilated cardiomy‐opathy（DCM ） patients and its calinical significance .Methods Fifty‐two DCM patients and contemporaneous 60 nor‐mal controls in our hospital from June 2010 to June 2013 were enrolled in this study and simultaneously deteced the level of peripheral blood SSTR2 and brain natriuretic peptide（BNP） by the enzyme‐linked immunosorbent assay （ELISA） .The detecion reults were comprehensively analyzed by combining with the general clinical data ,ultrasonic cardiogram and other seological indexes .The receiver operating characteristic （ROC） curves were drawn for evalua‐ting the diagnostic value of SSTR2 on DCM .Results The levels of SSTR2 and BNP in the DCM patients with the cardiac function grade Ⅲ‐Ⅳ were significantly higher than those in the control group ,the differences were statistical‐ly significant（P〈0 .05） ,but only the SSTR2 level in the DCM patients with the cardiac function grade Ⅱwas higher than that in the control group ,the difference was statistically significant（P〈0 .05） .The corelation analysis results showed that the levels of SSTR2 and BNP in the DCM patients with the cardiac function grade Ⅲ‐Ⅳ were negatively correlated with LVEF（r= -0 .53 ,r= -0 .43 ,P〈0 .05） ,but for the DCM patients with grade Ⅱ ,only the SSTR2 level was negatively correlated with LVEF（r= -0 .45 ,P〈0 .05） .The ROC curves demonstrated that the area under the curve（AUC） of SSTR2 in the DCM patients with gradeⅡwas 0 .702 ,which was superior to the AUC （0 .573） of BNP .Conclusion The increase of SSTR2 level is closely associated with cardiomyocyte hypertrophy ,myocardial fi‐brosis and heart failure of DCM patients .Especially for the DCM patients with cardiac function gradeⅡ ,SSTR2 has higher sensitivity than BNP and can timely reflect the early cardiac insufficiency and is a potential biological indica‐to r .