赖氨酰氧化酶样蛋白2对慢性心力衰竭患者的诊断价值探讨

Role of Serum Lysyl Oxidase Like 2 in the Diagnosis of Heart Failure

研究慢性心力衰竭患者血清赖氨酰氧化酶样蛋白2(lysyl oxidase like 2,LOXL2)水平变化情况,探讨LOXL2在心力衰竭诊断中的应用价值。入选心力衰竭住院患者74例,按纽约心功能分级标准分为心功能Ⅱ级组26例、心功能Ⅲ级组27例、心功能Ⅳ级组21例,并收集38例同期住院非心衰患者作为对照组。采集入选者的临床资料,入院后行心脏彩色超声检查,测定血浆NT-pro BNP水平,采用酶联免疫法测定血清LOXL2浓度。患者血清LOXL2水平在心功能Ⅳ级组(992.1±404.5)pg/mL显著高于心功能Ⅲ,Ⅱ级组[分别为(637.1±125.8)和(467.5±88.7)pg/mL,均P<0.01]及对照组[(314.2±143.5)pg/mL,P<0.01],与对照组相比,各组心衰患者LOXL2水平均显著升高(均P<0.05)。LOXL2浓度与左室舒张末期内径(LVEDd)呈正相关(R^2=0.25,P<0.01)、而与心功能分级(R^2=-0.26,P<0.01)呈负相关。血清LOXL2诊断心力衰竭的ROC曲线下面积(AUC)为0.699,95%可信区间为(0.644~0.894,P<0.001)。心力衰竭患者血清LOXL2水平明显升高,并且升高水平与心力衰竭程度显著相关。LOXL2或可作为NT-pro BNP和超声心动图外的补充手段,对心力衰竭的诊断与鉴别有一定意义。

To investigate the roles of serum lysyl oxidase like 2（LOXL2） level in patients with heart failure（HF）,this study included 74 hospitalized patients with HF.Of whom,26 were classified as NYHA functional class II patients,27 were NYHA III,and21 were NYHA Ⅳ patients.Thirty-eight control subjects without HF were recruited as control group.All subjects accepted UCG examination at admission and the serum aminoterminal B-type natriuretic peptide（NT-pro BNP） were measured.LOXL2 levels were determined by enzyme-linked immunosorbent assays.The levels of serumLOXL2 were significantly higher in patients with NYHA functional class Ⅳ（992.1 ± 404.5） pg/mL than in patients with NYHA Ⅲ（637.1 ± 125.8） pg/mL,P 0.01 and patients with class Ⅱ（467.5 ± 88.7） pg/mL,P 0.01.Furthermore,all group of HF patients had higher levels of LOXL2 than those in controls group（all P 0.05）.Correlation analysis further demonstrated that the serum LOXL2 levels were correlated with the left ventricular end-diastolic diameter（LVEDd）（R^2= 0.25,P 0.01） and left ventricular ejection fraction（LVEF）（R^2=-0.26,P 0.01）.Received characteristic curves（ROC） for diagnosis of heart failure demonstrated an AUC of 0.699（0.674 ~ 0.894,P 0.001） for LOXL2（P 0.01）.In addition,the ROC of NT-pro BNP for diagnosis of heart failure had an AUC of 0.863（0.781 ~ 0.944,P 0.001）.The level of serum LOXL2 is significantly increased in patients with HF.It may be a new biomarker of HF and can provide additive information to NT-pro BNP levels in the diagnosis of HF.