心力衰竭合并肺动脉高压患者Gal-3、HMGB1及copeptin水平变化及临床意义

Changes and clinical significance of Gal-3,HMGBl and copeptin levels in patients with pulmonary hypertension and heart failure

目的分析心力衰竭合并肺动脉高压患者血液中半乳糖凝集素3(Gal-3)、高迁移率组蛋白BI(HMGB1)及和肽素(copeptin)的水平变化及临床意义。方法选取2019年6月至2020年6月河南省胸科医院收治的108例心力衰竭合并肺动脉高压(观察组),根据肺动脉压分为轻度组43例和中重度组65例;选取同期收治的102例单纯心力衰竭患者作为对照组。比较不同人群、不同肺动脉压分级患者Gal-3、HMGB1及copeptin水平变化,分析Gal-3、HMGB1及copeptin与肺动脉压分级的相关性以及对心力衰竭合并肺动脉高压诊断价值。结果观察组Gal-3、HMGB1及copeptin水平均明显高于对照组,差异均有统计学意义(P<0.05)。轻度组Gal-3、HMGB1及copeptin水平均明显低于中重度组,差异均有统计学意义(P<0.05)。Pearson检验结果显示,Gal-3、HMGB1及copeptin与肺动脉压分级为正相关(P<0.05)。ROC曲线结果显示,Gal-3+HMGB1+copeptin三者联合者诊断心力衰竭合并肺动脉高压灵敏度和特异度分别为86.10%、76.20%,AUC=0.826,明显高于三者单独检测(P<0.05)。结论心力衰竭合并肺动脉高压者Gal-3、HMGB1及copeptin表达均上调,三者可为患者临床诊断提供参考依据。

Objective To analyze the changes and clinical significance of galectin 3(Galectin 3,Gal-3),high mobility histone B1(HMGB1)and copeptin(copeptin)levels in the blood of patients with pulmonary hypertension and heart failure.Methods 108 patients with heart failure and pulmonary hypertension admitted to this hospital from June 2019 to June 2020(observation group)were selected.According to the pulmonary artery pressure,they were divided into a mild group of 43 cases and a moderate to severe group of 65 cases,102 patients with simple heart failure admitted in the same period were selected as the control group.The changes in the levels of Gal-3,HMGB1 and copeptin in different groups and in patients at different grades of pulmonary artery pressure were compared,and the correlation between the levels of Gal-3,HMGB1 and copeptin and the grade of pulmonary artery pressure and the diagnostic value of heart failure with pulmonary hypertension were analyzed.Results The levels of Gal-3,HMGB1,and copeptin in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of Gal-3,HMGB1,and copeptin in the mild group were significantly higher than those in the moderate-to-severe group,and the differences were statistically significant(P<0.05).Pearson test showed that Gal-3,HMGB1 and copeptin were positively correlated with the pulmonary artery pressure classification(P<0.05).The ROC curve results showed that the sensitivity and specificity of Gal-3+HMGB1+copeptin in the diagnosis of heart failure with pulmonary hypertension were 86.10%and 76.20%,respectively,and the AUC=0.826,which was significantly higher than that of the three alone(P<0.05).Conclusion The expressions of Gal-3,HMGB1 and copeptin were all up-regulated in patients with heart failure complicated with pulmonary hypertension,which can provide reference for the clinical diagnosis of patients.