联合检测血清因子水平在评估老年心力衰竭患者预后中的价值

Value of combined mensurement of serum factors levels in assessing the outcome of elderly HF patients

目的分析血清可溶性生长刺激表达基因2蛋白(sST2)、血管生成素2(Ang-2)联合胱抑素C(Cys C)水平在评估老年心力衰竭患者预后中的价值。方法回顾性分析我院收治的112例心力衰竭患者,按照预后将其分为预后不良组48例,预后良好组64例。同时选取同期在我院体检的健康受试者60例作为对照组。观察并记录2组血清sST2、Ang-2、Cys C水平等一般临床情况,分析sST2、Ang-2联合Cys C水平在评估心力衰竭患者预后的价值。结果3组患者sST2、Ang-2、Cys C水平比较有显著差异(P<0.01);预后不良组及预后良好组sST2[(2.36±0.55)μg/L、(1.73±0.42)μg/L vs(1.21±0.44)μg/L]、Ang-2[(301.25±71.24)ng/L、(213.93±49.31)ng/L vs(132.14±28.32)ng/L]、Cys C[(70.42±20.32)mg/L、(36.41±11.73)mg/L vs(12.32±3.35)mg/L]水平明显高于对照组(P<0.05);预后不良组sST2、Ang-2、Cys C水平明显高于预后良好组(P<0.05)。与sST2比较,Cys C检测特异性显著增高,Ang-2显著降低,Cys C、Ang-2检测敏感性显著增高(P<0.05);与Ang-2比较,Cys C和sST2检测特异性显著增高,差异有统计学意义(P<0.05)。与平行联合检测同指标比较,系列联合检测特异性显著增高,敏感性显著降低,差异有统计学意义(P<0.05),与sST2+Cys C比较,sST2+Ang-2+Cys C平行联合检测敏感性、系列联合检测特异性显著增高(P<0.05);与Ang-2+Cys C比较,sST2+Ang-2+Cys C平行联合检测敏感性显著增高,差异有统计学意义(P<0.05)。平行联合检测ROC曲线下面积分别为0.785、0.782和0.932,系列联合检测ROC曲线下面积分别为0.743、0.712和0.903,sST2+Ang-2+Cys C联合检测ROC曲线下面积显著高于sST2+Cys C、Ang-2+Cys C(P<0.05)。结论sST2+Ang-2+Cys C联合检测能有效提高对心力衰竭患者预后的预测准确度,值得临床推广。

Objective To analyze the value of serum sST2,Ang-2 and Cys C levels in assessing the outcome of elderly HF patients.Methods One hundred and twelve elderly HF patients admitted to our hospital from October 2016 to October 2017 were divided into poor outcome group(n=48)and good outcome group(n=64)with 60 healthy subjects who underwent physical examination in our hospital served as a control group.The serum sST2,Ang-2 and Cys C levels in poor outcome group and good outcome group were measured and their value in assessing the outcome of elderly HF patients was analyzed.Results A significant difference in serum sST2,Ang-2 and Cys C levels was detected in the 3 groups(P<0.01).The serum sST2,Ang-2 and Cys C levels were significantly higher in poor outcome group and good outcome group than in control group(2.36±0.55μg/L and 1.73±0.42μg/L vs 1.21±0.44μg/L,301.25±71.24 ng/L and 213.93±49.31 ng/L vs 132.14±28.32 ng/L,70.42±20.32 mg/L and 36.41±11.73 mg/L vs 12.32±3.35 mg/L,P<0.05)and in poor outcome group than in good outcome group(P<0.05).The specificity of Cys C was significantly higher while that of Ang-2 was significantly lower than that of sST2(P<0.05).The specificity of Cys C and Ang-2 was significantly higher than that of sST2(P<0.05).The specificity of Cys C and sST2 was significantly higher than that of Ang-2(P<0.05).The specificity of combined detection was significantly higher than that of parallel detection while the sensitivity of combined detection was significantly lower than that of parallel detection(P<0.05).The sensitivity of parallel and combined detection of sST2+Ang-2+Cys C was significantly higher than that of parallel and combined detection of sST2+Cys C(P<0.05).The sensitivity of parallel detection of sST2+Ang-2+Cys C was significantly higher than that of parallel detection of Ang-2+Cys C(P<0.05).The area under the ROC curve for combined detection of sST2+Cys C and Ang-2+Cys was significantly higher than that of parallel detection of sST2+Cys C and Ang-2+Cys(P<0.05).Conclusion Combined detection of sST2+Ang-2+Cys C can effectively and accurately predict the outcome of elderly HF patients and is thus worthy of popularization in clinical practice.