N端脑钠肽前体、可溶性人基质裂解素2及血小板/淋巴细胞比值对慢性心力衰竭的诊断价值

The diagnostic value of N-terminal pro-brain natriuretic peptide,soluble human stromelysin-2 and platelet-lymphocyte ratio in chronic heart failure

目的:探讨N端脑钠肽前体(NT-proBNP)、可溶性人基质裂解素2(sST2)、血小板/淋巴细胞比值(PLR)三者联合检测在慢性心力衰竭(CHF)患者中的诊断价值。方法:选取我院128例CHF患者作为CHF组,并根据左室射血分数(LVEF)将其分为射血分数降低(HFrEF,LVEF<40%,48例)、射血分数中间值(HFmrEF,LVEF 40%~49%,52例)和射血分数保留(HFpEF,LVEF≥50%,28例)3个亚组。选取43例健康体检者为对照组。统计分析CHF组与对照组、CHF组不同亚组间NT-proBNP、sST2、PLR水平差异;二元Logistic回归分析CHF的危险因素;应用ROC曲线分析NT-proBNP、sST2、PLR及三指标联合对CHF的诊断价值。结果:与对照组相比,CHF组NT-proBNP、sST2、PLR水平明显升高,且各亚组的NT-proBNP、sST2、PLR水平均存在显著差异(P<0.05)。二元Logistic回归提示NT-proBNP升高、sST2升高、PLR升高是CHF的独立危险因素(均P<0.05)。NT-proBNP、sST2、PLR三者诊断CHF的曲线下面积(AUC)分别为0.867、0.859、0.798,三者联合应用诊断CHF的AUC为0.978。结论:CHF患者血NT-proBNP、sST2、PLR水平升高,三者联合应用能够提高对CHF的诊断价值。

Objective:To investigate the diagnostic value of N-terminal pro-brain natriuretic peptide(NT-proBNP),soluble human stromelysin-2(sST2),and platelet-lymphocyte ratio(PLR)in patients with chronic heart failure(CHF).Methods:We selected 128 patients with CHF in our hospital as the CHF group.The CHF group was further divided into 3 subgroups according to the left ventricular ejection fraction(LVEF):reduced ejection fraction(HFrEF,LVEF<40%,n=48),mid-range ejection fraction(HFmrEF,LVEF 40%-49%,n=52)and preserved ejection fraction(HFpEF,LVEF≥50%,n=28).Other 43 healthy subjects were selected as the control group.Statistical analysis was conducted on the differences of NT-proBNP,sST2,PLR levels among the 3 subgroups in the CHF group and control group.Binary Logistic regression was used to analyze the risk factors of CHF.ROC curve was employed to analyze the diagnostic value of NT-proBNP,sST2,PLR alone and the combination of three indexes in CHF.Results:Compared with the control group,the CHF group had significantly higher levels of NT-proBNP,sST2,and PLR than those in the control group.Moreover,the levels of NT-proBNP,sST2,and PLR among each subgroup were significantly different.Binary Logistic regression showed that elevated PLR,NT-proBNP,and sST2 were independent risk factors for CHF.The areas under the curve of NT-proBNP,sST2,and PLR in CHF diagnosis were 0.867,0.859,and 0.798,respectively,whereas the area under the curve of combined application of the three indexes in the diagnosis of CHF was 0.978.Conclusion:The serum levels of NT-proBNP,sST2 and PLR in patients with CHF are increased,and the combined application of the three indexes can improve the diagnostic value for CHF.