慢性心力衰竭患者血清sST2与和肽素水平变化及相关性分析

Change of serum sST2 and copeptin levels in patients with chronic heart failure and their correlation

目的:探讨血清可溶性ST2(sST2)及和肽素水平在慢性心力衰竭(CHF)患者的变化及其诊断价值。方法:收集2015年6月1日至2015年12月1日在我院心内科住院的CHF患者80例作为CHF组,同时收集心脏神经官能症或心律失常患者30例作为心功能正常组。根据NYHA心功能分级,CHF组进一步分为Ⅱ级组(22例)、Ⅲ级组(32例)和Ⅳ级组(26例)。检测并比较各组血清sST2及和肽素水平,并分析其相关性。结果:与心功能正常组比较,CHF组血清sST2[(0.27±0.09)ng/ml比(1.18±0.81)ng/ml]及和肽素[(1239.64±229.98)pg/ml比(1987.16±426.84)pg/ml]水平均显著升高,P均<0.01。与Ⅱ级组比较,Ⅲ级和Ⅳ级组的血清sST2[(0.46±0.17)ng/ml比(0.77±0.18)ng/ml比(2.31±0.29)ng/ml]及和肽素[(1625.61±522.13)pg/ml比(2103.15±340.74)pg/ml比(2194.31±332.97)pg/ml]水平均显著升高,且Ⅳ级组的显著高于Ⅲ级组,P<0.05或<0.01。Pearson积矩相关分析显示CHF患者血清sST2与和肽素水平呈显著正相关(r=0.66,P=0.005)。结论:血清sST2及和肽素水平与心力衰竭的严重程度密切相关,可作为心力衰竭的标志物,值得推广。

Objective： To observe change of peripheral serum levels of soluble ST2 （sST2） and copeptin in patients with chronic heart disease （CHF）, and explore their diagnostic value for heart failure. Methods： A total of 80 CHF patients, who hospitalized in our department of cardiology from Jun 1st, 2015 to Dec 1st, 2015, were selected as CHF group. Meanwhile, another 30 patients with cardiac neurosis or arrhythmia were regarded as normal cardiac function group. According to NYHA classification, CHF group was further divided into class II group （n= 22）, class III group （n = 32） and class IV group （n = 26）. Serum sST2 and copeptin levels were measured and compared among all groups, and their correlation was analyzed. Results： Compared with normal cardiac function group, there were significant rise in serum levels of sST2 [（0.27 ± 0.09） ng/ml vs. （1.18±0.81） ng/ml] and copeptin [（1239.64 ±229.98） pg/ml vs. （1987. 16 ±426.84） pg/ml] in CHF group, P〈0.01 both. Compared with class II group, there were significant rise in serum levels of sST2 [ （0.46±0.17） ng/ml vs. （0.77± 0.18） ng/ml vs. （2.31 ± 0.29） ng/ml] and copeptin [ （1625.61 ±522.13） pg/ml vs. （2103.15 ± 340.74） pg/ml vs. （2194.31 ±332.97） pg/ml] in class III and class IV group, and those of class IV group were significantly higher than those of class III group, P〈 0.05 or 〈0.01. Pearson product-moment correlation analysis indicated that serum sST2 level was significant positively correlated with serum copeptin level in CHF group （r = 0.66, P = 0. 005）. Conclusion.. Serum sST2 and copeptin levels are closely associated with severity of heart failure. They can be used as markers for heart failure, which is worth extending.