血管内皮生长因子和性别决定区Y-17对慢性心力衰竭的诊断价值

The diagnostic value of VEGF and SOX17 in chronic heart failure

目的本研究旨在探索血管内皮生长因子(vascular endothelialgrowth factor,VEGF)与性别决定区Y-17(sex determining region Y-box 17,SOX17)作为血清学标志物在慢性心力衰竭诊断中的价值。方法选取2020年1月-2021年1月在上海交通大学医学院附属仁济医院住院治疗的慢性心力衰竭患者50例,设立为观察组,50名健康者设立为对照组。使用ELISA测定2组研究对象血清VEGF、SOX17含量,比较2组之间差异、进行Logistics回归分析,构建风险值计算公式、蛋白质相互作用网络、和京都基因和基因组百科全书(Kyoto Encyclopediaof Genes and Genomes,KEGG)信号通路富集分析。通过受试者工作特征(Receiver operating characteristic,ROC)曲线,评估VEGF、SOX17以及风险值诊断效能。结果观察组血清VEGF含量高于对照组(P<0.001)血清,SOX17含量高于对照组(P<0.001);SOX17(OR=1.32,95%CI[0.96,1.36])和VEGF(OR=1.41,95%CI[1.06,1.62])(P<0.05)。风险值计算公式为:风险值=-2.96+0.01×血清SOX17含量+0.02×血清VEGF含量。SOX17、VEGF、风险值的曲线下面积(AUC)分别为0.67、0.76、0.81,最佳临界值以及对应的敏感度和特异度分别为115.89 pg/mL(0.48,0.82)、79.32pg/mL(0.76,0.74)、0.60(0.78,0.82)。结论VEGF和SOX17均可以独立用于慢性心力衰竭的诊断,并且诊断效能良好。VEGF和SOX17联合构建的风险值作为诊断指标,其效能高于两者独立作为诊断指标。

Objective To explore the value of vascular endothelial growth factor(VEGF)and sex determining region Y-box 17(SOX17)in the diagnosis of chronic heart failure.Methods A total of 50 patients with chronic heart failure hospitalized in the Renji Hospital from January 2020 to January 2021 were recruited and set as the observation group,and another 50 healthy people were set as the control group.The levels of serum VEGF and SOX17 of the two groups were measured by ELISA,and the differences between the two groups were compared.The logistic regression analysis was performed,and risk value calculation formula,protein interaction network,and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analysis were constructed.The diagnostic efficacy of VEGF,SOX17 and risk value was evaluated by receiver operating characteristic(ROC)curve.Results The levels of serum VEGF and SOX17 of the observation group were significantly higher than those of the control group(P<0.001);SOX17(OR=1.32,95%CI[0.96,1.36])and VEGF(OR=1.41,95%CI[1.06,1.62])were independent risk factors for chronic heart failure(P<0.05).The formula for calculating the risk value was as follows:risk value=-2.96+0.01×serum SOX17 level+0.02 xserum VEGF level.The area under the curve(AUC)of SOX17,VEGF and risk value were 0.67,0.76 and 0.81,respectively.The optimal cut-off value and corresponding sensitivity and specificity were115.89 pg/mL(0.48,0.82),79.32 pg/mL(0.76,0.74)and 0.60(0.78,0.82),respectively.Conclusion Both VEGF and SOX17 can be used independently in the diagnosis of chronic heart failure,and the diagnostic efficiency is good.The diagnostic efficiency of the risk value that is constructed by VEGF and SOX17 is higher than that of VEGF or SOX17 alone as a diagnostic index.