血清sST2、CA125、甲状腺激素、NT-proBNP水平对慢性心力衰竭患者预后评估的临床价值

Value of sST2,CA125,thyroid hormone and NT-pro BNP levels in predicting the prognosis of patients with chronic heart failure

目的分析血清可溶性生长刺激表达基因2蛋白(sST2)、糖链抗原125(CA125)、甲状腺激素、N端脑钠肽前体(NT-proBNP)水平对慢性心力衰竭患者预后的评估价值。方法选择2015年2月-2017年4月于厦门市海沧医院心内科住院的慢性心力衰竭患者120例作为观察对象,根据纽约心脏病学会(NYHA)分级标准分为Ⅰ~Ⅱ级组、Ⅲ级组和Ⅳ级组,每组40例;另选取同期健康体检正常者40例作为对照组,检测并比较各组血清sST2、CA125、甲状腺激素、NT-proBNP水平;慢性心力衰竭患者出院后随访1年,根据终点事件发生与否分为A组(有终点事件)和B组(无终点事件),采用二分类Logistic回归分析影响慢性心力衰竭预后的因素,并采用ROC曲线分析各标志物联合检测评估慢性心力衰竭预后的临床价值。结果慢性心力衰竭患者血清sST2、CA125、NT-proBNP水平均高于对照组(P<0.05),且随着心功能级别的升高,sST2、CA125、NT-proBNP水平逐渐升高(P<0.01);慢性心力衰竭患者血清FT_(3)水平低于对照组(P<0.05),且随着心功能级别的升高,FT_(3)水平逐渐降低(P<0.01);各组血清FT4及TSH水平比较差异均无统计学意义(P>0.05)。A组血清sST2、CA125、NT-proBNP水平高于B组(P<0.05),FT_(3)水平低于B组(P<0.05),血清sST2、CA125、NT-proBNP、FT_(3)水平对心力衰竭预后有独立预测意义(P<0.05)。sST2联合FT_(3)检测、FT_(3)联合NT-proBNP检测、sST2联合CA125检测、sST2联合NT-proBNP检测对心力衰竭预后评估价值均优于NT-ProBNP单独检测。结论血清sST2、CA125、FT_(3)均可与NT-proBNP联合检测以评估慢性心力衰竭患者的预后。

Objective To analyze the prognostic value of serum soluble growth-stimulating expression gene 2 protein(sST2),sugar chain antigen 125(CA125),thyroid hormone and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels in predicting the prognosis of patients with chronic heart failure.Methods 120 patients with chronic heart failure who were hospitalized in the Department of Cardiology,Xiamen Haicang Hospital from February 2015 to April 2017 were selected as observation objects,according to NYHA grading standards,they were divided into gradeⅠ~Ⅱgroup,gradeⅢgroup and gradeⅣgroup,40 cases in each group.In addition,40 cases with normal physical examination during the same period were selected as the control group,and the levels of serum sST2,CA125,thyroid hormone and NT-proBNP in each group were detected and compared.After patients with chronic heart failure were discharged from the hospital followed up for 1 year,according to the occurrence of end-point events,they were divided into group A(end-point event)and group B(no end-point event),and analysed the factors affecting prognosis of heart failure by binary logistic regression,and analysed the value of joint detection of various markers in predicting the prognosis of heart failure by ROC curve.Results The levels of serum sST2,CA125 and NTpro BNP in patients with chronic heart failure were higher than those in the control group(P<0.05),and as the lever of cardiac fuction rises,the levels of sST2,CA125,NT-proBNP were further elevated(P<0.01).The serum FT_(3) level of patients with chronic heart failure was lower than that of the control group(P<0.05),and as the level of cardiac function increased,the FT_(3) level gradually decreased(P<0.01).There were no significant difference in serum FT4 and TSH levels among the groups(P>0.05).The levels of sST2,CA125,NT-proBNP in group A were higher than group B(P<0.05),and the lever of FT_(3) was lower than group B(P<0.05),the levels of sST2,CA125,NT-proBNP and FT_(3) had independent prediction significance for the prognosis of heart failure(P<0.05).The value of joint detection of sST2 and FT_(3),FT_(3) and NT-proBNP,sST2 and CA125 in predicting the prognosis of heart failure were better than separate detection of NT-pro BNP.Conclusion sST2,CA125 and FT_(3) all can be joint detected with NT-pro BNP in predicting the prognosis of chronic heart failure.