可溶性ST_(2)、TNF-α及NT-proBNP表达水平对慢性心力衰竭患者心功能评估价值的研究

Study on the value of soluble ST_(2),TNF-αand NT-proBNP expression levels in evaluating cardiac function of patients with chronic heart failure

目的:探讨慢性心力衰竭(CHF)患者血清中可溶性ST2(sST2)、肿瘤坏死因子-α(TNF-α)及氨基末端脑钠肽前体(NT-proBNP)表达水平与心功能变化的关系。方法:2020年3-9月收治CHF患者90例;选择同期健康体检人群30例,作为对照组。通过6 min步行试验对CHF患者进行心功能分级,分为轻度(>450 m)、中度(150~450 m)、重度(<150 m)三组,检测sST2、TNF-α及NT-ProBNP的表达水平。结果:CHF患者三项指标的表达水平均高于对照组,差异有统计学意义(P<0.05);CHF患者随着心功能分级严重程度的增加,三项指标表达水平明显升高,差异有统计学意义(P<0.05);三项指标对CHF的联合检测,ROC曲线下面积0.944,高于单一指标检测结果。结论:sST2、TNF-α及NT-proBNP的表达水平随CHF患者心功能分级加重呈上升趋势,可作为CHF诊断及心功能评价的依据,三者联合检测对诊断具有重要意义。

Objective:To investigate the relationship between the levels of soluble ST2(sST2),tumor necrosis factor-α(TNF-α)and N-terminal brain natriuretic peptide(NT-proBNP)in serum of patients with chronic heart failure(CHF)and changes in cardiac function.Methods:From March to September 2020,90 cases of CHF patients were enrolled,and 30 healthy people were selected as the control group at the same period.The cardiac function of CHF patients was classified into three groups:mild(>450 m),moderate(150 m)and severe(<150 m)by 6 min's walking tests.The expression levels of sST2,TNF-αand NT-ProBNP were detected.Results:The expression levels of the three indexes in CHF patients were significantly higher than those in the control group,the differences were statistically significant(P<0.05).As the severity of cardiac function classification increased in patients with CHF,the expression levels of the three indexes increased significantly,the differences were statistically significant(P<0.05).Combined testing of CHF by three indexes,the area under the ROC curve was 0.944,which was higher than the single index detection result.Conclusion:The expression levels of three indexes show an upward trend with the aggravation of the cardiac function classification of CHF patients,which can be used as a basis for CHF diagnosis and cardiac function evaluation,and the combined detection of the three is of great significance for diagnosis.