冠心病合并心力衰竭患者血清Adropin、sST2、BNP水平与预后的关系分析

The Relationship Between Serum Adropin,sST2,BNP Levels andPrognosis in Patients with Coronary Heart Disease and Heart Failure

目的分析冠心病合并心力衰竭(HF)患者血清Adropin、可溶性生长刺激表达基因2蛋白(sST2)、脑钠肽(BNP)水平与预后的关系。方法选取2016年3月至2019年2月期间于我院住院治疗的95例冠心病合并HF患者作为研究对象,均接受常规抗心衰治疗并随访1年。依据随访1年后的预后情况,将随访期间未发生心脏不良事件的患者划分为预后良好组(n=59),发生心脏不良事件的患者划为预后不良组(n=36),检测两组患者的血清标本中Adropin、sST2、BNP的表达水平,并采用单因素、多因素Logisitic回归分析以及ROC曲线分析血清Adropin、sST2、BNP对冠心病合并HF患者预后的评估价值。结果经检测,预后不良组血清Adropin、sST2、BNP水平均明显高于预后良好组(P<0.05)。单因素分析结果显示,两组在心功能分级、血清Adropin、sST2、BNP表达方面差异存在统计学意义(P<0.05);多因素回归分析结果显示,心功能IV级、血清Adropin≥6.0 ng/mL、血清sST2≥1.2μg/L和血清BNP≥350 pg/mL是冠心病合并HF患者预后不良的独立预测因素;ROC曲线分析结果显示,血清Adropin、sST2、BNP单独评估冠心病合并HF患者预后不良的ROC曲线下面积分别为0.667、0.804、0.732,均低于三指标联合预测的ROC曲线下面积0.902(P<0.05)。结论血清Adropin、sST2、BNP水平在冠心病合并HF预后不良患者血清中呈较高水平,三者联合检测对于冠心病合并HF患者预后的评估具有较好的应用价值。

Objective To analyze the relationship between serum adropin,soluble growth-stimulating expression gene 2(sST2),brain natriuretic peptide(BNP)levels and prognosis in patients with coronary heart disease(CHD)and heart failure(HF).Methods A total of 95 patients with CHD and HF who were hospitalized from March,2016 to February,2019 were prospectively enrolled as the research subjects.All patients underwent the routine anti-HF treatment and were followed up for 1 year.According to prognosis after 1 year of follow-up,59 cases without adverse cardiac events during the follow-up were included into the good prognosis group,while another 36 cases with adverse cardiac events were included into the poor prognosis group.The expression levels of adropin,sST2 and BNP in serum samples of both groups were detected.And the evaluation values of these markers for the prognosis of patients with CHD and HF were analyzed by univariate analysis,multivariate logisitic regression analysis and ROC curves.Results After tests,levels of serum adropin,sST2 and BNP in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).The results of univariate analysis showed that there were significant differences in cardiac function grading,expression of serum adropin,sST2,and BNP between the two groups(P<0.05).The results of multivariate regression analysis showed that cardiac function grading at grade IV,serum adropin not lower than 6.0 ng/mL,serum sST2 not lower than 1.2μg/L and serum BNP not lower than 350 pg/mL were all independent predictors of the poor prognosis in patients with CHD and HF.The results of ROC curve analysis showed that areas under the curve(AUC)of serum adropin,sST2 and BNP for evaluating poor prognosis were 0.667,0.804 and 0.732,respectively,which were lower than that of their combination(0.902)(P<0.05).Conclusion Serum adropin,sST2 and BNP are highly expressed in patients with a poor prognosis.The combined detection of the three is of good application value in assessing prognosis of patients with CHD and HF.