心力衰竭患者血浆CTRP3、血管生成素样蛋白2、sST2的浓度及预后价值

Plasma concentrations of CTRP3,angiopoietin like protein 2,sST2 and their prognostic value in patients with heart failure

目的探讨心力衰竭患者血浆补体C1q肿瘤坏死因子相关蛋白3(C1q tumor necrosis factor related proteins-3,CTRP3)、血管生成素样蛋白2(angiopoietin like protein 2,angptl2)、可溶性致癌抑制因子2(soluble suppression of tumorigenicity 2,sST2)的浓度及预后价值。方法选择2014年8月到2018年2月在北京市垂杨柳医院心内科收治的心力衰竭患者122例作为心力衰竭组,并分为收缩性心力衰竭组62例和舒张性心力衰竭组60例两个亚组;对照组为非心力衰竭人群122例。采用酶联免疫吸附法检测混杂血浆CTRP3、angptl2、sST2浓度,随访调查患者的预后并进行相关性分析与预测价值分析。结果心力衰竭组的左心室射血分数(left ventricular ejection fraction,LVEF)低于对照组,左心室舒张末期内径(left ventricular end diastolic dimension,LVEDD)及血尿素、肌酐浓度高于对照组,差异有统计学意义(P<0.05)。两组总胆固醇、低密度脂蛋白胆固醇浓度比较,差异无统计学意义(P>0.05)。两亚组心功能与生化指标比较,差异无统计学意义(P>0.05)。心力衰竭组的血浆angptl2、sST2浓度高于对照组,CTRP3浓度低于对照组,差异有统计学意义(P<0.05);两亚组CTRP3、angptl2、s ST2浓度比较,差异无统计学意义(P>0.05)。随访至今,心力衰竭组患者中预后不良16例,发生率为13.1%。Pearson相关分析结果显示CTRP3、angptl2、sST2、LVEF、LVEDD、尿素、肌酐都与心力衰竭患者预后显著相关(P<0.05)。Cox回归模型分析显示CTRP3、angptl2、sST2为影响心力衰竭患者预后的主要因素(P<0.05)。结论心力衰竭患者血清CTRP3、angptl2、sST2浓度呈现异常表达情况,具有预测预后不良的价值,是心力衰竭预后评估的生物学标志物。

Objectives To investigate plasma concentrations and prognostic values of C1 q tumor necrosis factor re-lated proteins-3(CTRP3),angiopoietin like protein 2(Angptl2)and soluble suppression of tumorigenicity 2(s ST2)inpatients with heart failure.MethodsFrom August 2014 to February 2018,122 patients with heart failure in the De-partment of Cardiology of Beijing Chui Yang Liu Hospital were selected as heart failure group,and they were divided in-to two subgroups:systolic heart failure group(62 cases)and diastolic heart failure group(60 cases).At the sameperiod,122 cases with non heart failure were selected as control group.Plasma concentrations of CTRP3,Angptl2 ands ST2 were detected by enzyme immunoassay.The prognosis of the patients was followed up and the correlation analysiswas carried out to analyze the prediction values.ResultsLeft ventricular ejection fraction(LVEF)in heart failuregroup was significantly lower than that in control group(P<0.05).Left ventricular end diastolic dimension(LVEDD),concentrations of urea and creatinine in heart failure group were significantly higher than those in control group(P<0.05).There were no statistical differences of concentrations of total cholesterol and low-density lipoprotein-cholesterolbetween the two groups(P>0.05).There were no significant differences in heart function and biochemical indexesbetween systolic and diastolic heart failure subgroups(P>0.05).Plasma concentrations of Angptl2 and s ST2 in heartfailure group were significantly higher than those in control group(P<0.05).Plasma concentration of CTRP3 wassignificantly lower than that in control group(P<0.05).There were no significant differences in plasma concentrationsof CTRP3,angptl2,s ST2 between systolic heart failure subgroup and diastolic heart failure subgroup(P>0.05).Up tonow,there were 16(13.1%)patients with poor prognosis in the patients with heart failure.Pearson analysis showed thatCTRP3,Angptl2,s ST2,LVEF,LVEDD,urea and creatinine correlated with the prognosis of patients with heart failure(P<0.05).Cox proportional risk regression model showed that CTRP3,angptl2,s ST2 were the main factors affectedthe prognosis of patients with heart failure(P<0.05).ConclusionsThe abnormal expressions of plasma concentrationsof CTRP3,Angptl2 and s ST2 in patients with heart failure have the value of predicting prognosis,which can be thebiological markers for the prognosis evaluation of heart failure.