可溶性生长刺激表达基因2蛋白作为血清标志物预测心力衰竭预后的Meta分析

Soluble growth STimulation expressed gene 2 as a serum biomarker for predicting prognosis of heart failure:a Meta-analysis

目的系统评价可溶性生长刺激表达基因2蛋白(sST2)作为血清标志物与心力衰竭(心衰)患者预后的关系。方法计算机检索中国知网(CNKI)、维普(VIP)、万方数据知识服务平台、中国生物医学文献服务系统(CBM)、PubMed、Cochrane Library、EMbase数据库,搜索建库以来至2020年4月23日关于血清sST2与心衰预后的文章。由2名评价员独立筛选文献、提取数据及文献质量评价,采用STATA 15.0软件进行Meta分析。结果sST2升高是心衰患者预后不良的预测因子。在sST2升高的心衰患者中,复合心血管事件(HR=1.51,95%CI:1.39~1.65,P<0.001)、全因死亡(HR=1.48,95%CI:1.00~2.20,P<0.001)发生的风险增加。亚组分析显示,sST2对于射血分数减低型心力衰竭(HFrEF)和射血分数保留型心力衰竭(HFpEF)复合心血管事件的预测能力存在差异(HR=2.11 vs.1.36),对于HFrEF的预测能力更强。结论sST2升高的心衰患者复合心血管事件及全因死亡的发生风险显著升高,预测能力受心衰类型影响,对于HFrEF的预测能力更强。

Objective To review systematically the relationship between soluble growth stimulation expressed gene 2(sST2)as a serum biomarker and prognosis in patients with heart failure(HF).Methods The databases of CNKI,VIP,WanFang Data,CBM,PubMed,Cochrane Library and EMbase were retrieved for searching articles related to serum sST2 and HF prognosis from database establishment time to Apr.23,2020.The literature was screened,data was extracted and quality of included literature was reviewed by 2 reviewers independently,and a Meta-analysis was conducted by using STATA 15.0 software.Results The increased sST2 was a predictive factor of poor prognosis in HF patients.In HF patients with increased sST2,the risks of composite cardiovascular events(HR=1.51,95%CI:1.39~1.65,P<0.001)and all-cause mortality(HR=1.48,95%CI:1.00~2.20,P<0.001)increased.The results of subgroup analysis showed that sST2 had different predictive ability for heart failure with reduced ejection fraction(HFrEF)and heart failure with preserved ejection fraction(HFpEF,HR=2.11 vs.HR=1.36),and predictive ability was higher for HFrEF.Conclusion The risks of composite cardiovascular events and all-cause mortality increase significantly in HF patients with increased sST2,and predictive ability of sST2 is influenced by HF types,which is higher for HFrEF.