老年慢性心力衰竭患者心脏事件与外周血Adropin水平的相关性及其临床意义

Correlation between cardiac events and the level of serum Adropin in elderly patients with chronic heart failure and its clinical significance

目的探讨Adropin评估老年慢性心力衰竭(CHF)患者预后的价值。方法选取老年CHF住院患者60例,入院后常规行超声心动图测量心功能,采用ELISA测定血清Adropin水平。随访12个月,根据随访期内是否发生心脏不良事件分为心脏事件组和非事件组,分析Adropin水平与心脏事件的关系。结果心脏事件组血清Adropin水平、左室舒张末期内径(LVEDD)、左房内径(LAD)显著高于非事件组(均P<0.05或P<0.01),左室射血分数(LVEF)则低于非事件组(P<0.05)。LAD、Adropin是发生心脏事件的独立相关因素(P<0.05)血清Adropin水平对心力衰竭患者预后判定的受试者工作特征(ROC)曲线下面积为0.830(95%CI:0.724~0.936,P<0.01),符合预测心脏事件的条件。当截断值为11.84 ng/ml时,其敏感度73%,特异性83%。结论 CHF患者血清Adropin水平与心血管事件发生率有相关性,对于预测老年CHF患者发生心血管事件具有一定的临床价值。

AIM To investigate the prognostic value of Adropin in elderly patients with chronic heart failure （CHF）. METHODS A total of 60 patients with heart failure were enrolled in the study. Cardiac function was determined by echocardiography after admission. Serum Adropin was determined by enzyme-linked immunosorbent assay （ELISA）. The patients were followed for 12 months. According to the incidence of adverse cardiac events, the patients were divided into two groups： a cardiac event group and a non-event group. The relationship between the levels of serum Adropin and cardiac events was analyzed. RESULTS The levels of serum Adropin, LVEDD, LAD in the cardiac event group were significantly higher than the non-event group （P〈0.05 or P〈0.01）. LVEF levels were lower than that in the non-event group （P〈0.05） . LAD, Adropin were an independent risk factor for cardiac events （P〈0.05）. The area under ROC curve for predicting the prognosis of heart failure patients by seurm Adropin was 0.830 （95%CI： 0.724-0.936, P=0.000）, complying with prognostic condition for cardiac event. When the cutoff value of Adropin was 11.84 ng/ml, the sensitivity and specificity were 73% and 83%, respectively. The incidence of cardiac adverse events （86%, 24/28） in the high Adropin group was significantly higher than that （32%, 9/28） in the low Adropin group （P〈0.01）. CONCLUSION Serum Adropin levels in CHF patients are associated with cardiovascular events. There is a certain clinical value on the recurrence of cardiovascular events for serum Adropin in patients with CHF.