可溶性ST2与半乳糖凝集素-3对缺血性心脏病患者心力衰竭评估价值分析

Evaluation value of soluble ST2 and galectin-3 for heart failure in patients with ischemic heart disease

目的:观察缺血性心脏病患者可溶性ST2(sST2)和半乳糖凝集素-3(Gal-3)水平与心功能的关系。方法:选择缺血性心脏病导致慢性射血分数减低的心力衰竭患者179例(HF组),其中NYHA心功能Ⅱ级60例、Ⅲ级67例、Ⅳ级52例。另入选同期入院治疗的冠心病心功能Ⅰ级患者49例(非HF组)为对照。比较两组及HF组不同心功能分级之间血清sST2和Gal-3水平,分析血清sST2和Gal-3水平对缺血性心脏病患者心力衰竭的评估价值。结果:与非HF组比较,HF组血清sST2[(103.07±45.87)ng/ml比(152.33±48.84)ng/ml]和Gal-3[(84.56±40.54)ng/ml比(119.58±46.86)ng/ml]水平均显著升高(P均=0.001)。与心功能Ⅱ级组比较,Ⅲ级和Ⅳ级组Gal-3水平[(103.74±36.75)ng/ml比(123.56±51.48)ng/ml、(132.72±49.64)ng/ml]均显著升高(P<0.05或<0.01);sST2水平在不同心功能组间差异无显著性(P=0.136)。经ROC分析,sST2及Gal-3诊断缺血性心脏病患者HF的曲线下面积分别为0.769(P=0.001)和0.722(P=0.001)。结论:缺血性心脏病患者血清Gal-3水平随心功能恶化而显著升高,sST2和Gal-3具备评价缺血性心脏病患者心力衰竭的临床价值。

Objective:To observe the relationship among levels of soluble ST2(sST2),galectin(Gal)-3 and cardiac function in patients with ischemic heart disease(IHD).Methods:A total of 179 patients with heart failure(HF)and chronic reduced ejection fraction caused by IHD were regarded as HF group,including 60 cases with NYHA cardiac class II,67 cases with class III and 52 cases with class IV.Another 49 patients with coronary heart disease and NYHA class I,who were treated simultaneously,were regarded as non-HF group for control.Serum levels of sST2 and Gal-3 were compared between two groups and among HF subgroups.Evaluation value of serum sST2 and Gal-3 levels for HF in IHD patients were analyzed.Results:Compared with non-HF group,there were significant rise in serum levels of sST2[(103.07±45.87)ng/ml vs.(152.33±48.84)ng/ml]and Gal-3[(84.56±40.54)ng/ml vs.(119.58±46.86)ng/ml]in HF group,P=0.001 both.Compared with NYHA class II group,there was significant rise in serum Gal-3 level[(103.74±36.75)ng/ml vs.(123.56±51.48)ng/ml,(132.72±49.64)ng/ml]in class III group and class IV group,P<0.05 or<0.01;there was no significant difference in serum sST2 level among NYHA class II,III and IV group,P=0.136.ROC analysis indicated that area under the curve(AUC)of sST2 and Gal-3 diagnosing HF in IHD patients was0.769 and 0.722 respectively,P=0.001 both.Conclusion:Serum Gal-3 level significantly rises along with cardiac function aggravates in IHD patients.The sST2 and Gal-3 possess evaluation value for heart failure in IHD patients.