可溶性ST2和氨基末端脑钠肽前体对心力衰竭诊断及预后评估的价值

The significance of soluble ST2 and NT-proBNP in the diagnosis and prognosis evaluation in patients with heart failure

目的 通过对心力衰竭(HF)不同心功能分级的患者氨基末端脑钠肽前体(NT-proBNP)和可溶性ST2血清学水平的检测,探究其与HF诊断及预后的关系.方法 选取2018年12月至2019年12月十堰市人民医院就诊的HF患者共119例作为HF组,选取同期住院的非HF患者共54例作为对照组,测量其血清可溶性ST2和NT-proBNP水平,对其进行1年随访,记录其再住院及死亡情况,并对相关结果进行统计学分析.结果 随着NYHA心功能分级升高,血清NT-proBNP和可溶性ST2水平逐渐升高.可溶性ST2水平有利于优化心功能分级.NT-proBNP、可溶性ST2及两者联合应用诊断HF的ROC曲线下面积分别为0.833、0.683和0.830.NT-proBNP、可溶性ST2及两者联合应用预测HF患者1年内发生不良预后的ROC曲线下面积分别为0.698、0.773和0.738.NT-proBNP、可溶性ST2及两者联合应用预测HF患者1年内死亡的ROC曲线下面积分别为0.766、0.844和0.792.结论 可溶性ST2对HF的诊断价值不如NT-proBNP,但在预后方面可溶性ST2显著优于NT-proBNP,是HF预后不良的独立预测因子.

Objective To explore the sific of soluble ST2 and NT-proBNP levels in the diagnosis and prgnosis in patiens with dffent NYHA cssifction Methods A total of 119 patiens with heart failure were rcnuiteded as the heart failure group and 54 patiens with non-heart filure who were hospitaliid during the same period were erolld as the control group.The serum soluble ST2 and NT-proBNP levels were measured and analyzed.Fllwup was performed to record the radmisson and death within 1 year and the satitical analsis was carried out.Results As NYHA cardiac funtion grade increased,serum soluble ST2 and NT-proBNP levels gradulll increased.The level of soluble ST2 was benefcial for optimizing heart failure cssificion.The aras under the ROC curve for NT-proBNP,soluble ST2 and their combined use in diagnosing heart filure were 0.833,0.683 and 0.830,rspetively The ara under the ROC cuve of NT-proBNP,soule ST2 and the combinatin of them for predicting a poor progosis wihin one year in patients with heart failure were 0.68,0.733 and 0.738,respectively.The area under the ROC curve for NT-proBNP,soluble ST2 and the combination of them for predicting death witin 1 year in heart faiure patienr were 0.766,0.844 and 0.792,rspectivly Conelusion Soluol ST2 is not as valuale as NT-proBNP in the diagois of heart failure however,it is bettr than NT-proBNP in prognosis and is an independent predictor of poor prognosis of heart filure.