sST2、TN-C水平与维持性血液透析患者并发心血管事件的相关性

Correlation between ST2,TN-C levels and cardiovascular events in maintenance hemodialysis patients

目的:分析血清可溶性生长刺激基因表达蛋白2(soluble growth ST immolation expressed gene 2,sST2)、腱糖蛋白C(C-terminus,TN-C)水平与维持性血液透析(maintenance hemodialysis,MHD)患者并发心血管事件的相关性。方法:连续收集2018年3月至2020年3月南京医科大学附属江宁医院收治的MHD患者94例作为MHD组,另选同期在南京医科大学附属江宁医院体检年龄和性别上相匹配的51例健康志愿者作为对照组。比较两组血清sST2、TN-C水平,并通过多因素logistic回归分析MHD并发心血管事件的相关的危险因素。绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清sST2、TN-C对MHD并发心血管事件的预测价值。结果:MHD组患者平均sST2、TN-C水平明显高于对照组(均P<0.05);94例MHD患者中,共41例并发心血管事件,主要为心律失常、心功能降低、急性冠状动脉综合征、心肌梗死及心力衰竭。单因素初步结果显示年龄、透析时间、CRP、sST2、TN-C与MHD并发心血管事件有关;多因素logistic回归分析结果显示年龄、透析时间、CRP、sST2、TN-C为MHD并发心血管事件的独立危险因素;ROC曲线评价结果显示血清sST2预测MHD患者发生心血管事件价值较高,其中预测发生心血管事件的最佳临界值为58.6μg/L,AUC为0.800(95%CI:0.700~0.901)。结论:sST2、TN-C为MHD患者并发心血管事件的独立影响因素,患者体内水平明显异常,血清sST2对MHD患者并发心血管事件的预测价值较高。

Objective:To analyze the correlation between serum levels of soluble growth ST immolation expressed gene 2(sST2)and C-terminus(TN-C)and cardiovascular events in maintenance hemodialysis(MHD)patients.Methods:From March 2018 to March 2020,94 patients with MHD in our hospital were collected as the MHD group.In addition,51 healthy volunteers matched in age and gender were selected as the control group.The serum levels of sST2 and TN-C were compared between the 2 groups,and the related risk factors of MHD complicated with cardiovascular events were analyzed by multivariate logistic regression.In addition,receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of serum sST2 and TN-C in MHD complicated with cardiovascular events.Results:The average levels of sST2 and TN-C in MHD group were significantly higher than those in control group(all P<0.05);there were 41 cardiovascular events in 94 patients with MHD,including arrhythmia,cardiac dysfunction,acute coronary syndrome,myocardial infarction and heart failure;univariate screening showed that age,dialysis time,CRP,sST2 and TN-C were associated with cardiovascular events;multivariate logistic regression analysis showed that age,dialysis time,CRP,sST2 and TN-C were independent risk factors of cardiovascular events in MHD patients;the ROC curve showed that serum sst2 had a high value in predicting cardiovascular events in MHD patients.The optimal critical value for predicting cardiovascular events was 58.6μg/L and AUC was 0.800(95%CI:0.700–0.901).Conclusion:sST2 and TN-C are the independent influencing factors of cardiovascular events in MHD patients.The levels are significantly abnormal in MHD patients.Serum sST2 has higher predictive value for cardiovascular events in MHD patients.