血清sST2、Gal-3水平与心肌梗死后慢性心力衰竭患者预后相关性分析

Correlation among serum sST2 level,galectin-3 level and prognosis in patients with chronic heart failure after myocardial infarction

目的分析血清可溶性肿瘤因子2抑制剂(sST2)、半乳糖凝集素-3(Gal-3)水平与心肌梗死(心梗)后慢性心力衰竭(心衰)患者预后的相关性。方法研究对象为青岛市市立医院西院区于2019年1月至2020年1月收治的心梗后心衰患者304例,观察指标包括不同心功能分级患者的临床特征比较;sST2、Gal-3与心衰预后的关系以及评估预后的预测效能。依据预后结局将患者分为死亡组、恶化组及无异常组。结果随着患者心功能分级的加重,血清sST2、Gal-3水平逐渐升高,而左室射血分数(LVEF)水平逐渐降低,各分级间指标间具有显著差异(P<0.05)。死亡组、恶化组及无异常组患者的sST2、Gal-3水平均存在明显差异,其中死亡组的sST2、Gal-3水平明显高于恶化组及无异常组,而恶化组的sST2、Gal-3水平明显高于无异常组(P<0.05)。sST2>32.85 ng/ml而Gal-3>16.78 ng/ml是心衰患者恶化的预测因子,sST2>46.14 ng/ml而Gal-3>22.01 ng/ml是心衰患者死亡的预测因子;sST2高表达组的总体生存率明显低于sST2低表达组,Gal-3高表达组的总体生存率明显低于Gal-3低表达组。结论血清sST2、Gal-3均可有效预测心衰患者的心脏事件恶化及预后转归,两者联合对心衰诊断及预后预测有一定的参考价值。

Objective To analyze the correlation among serum soluble suppression of tumorigenicity 2(sST2)level,galectin-3(Gal-3)level and prognosis in patients with chronic heart failure(CHF)after myocardial infarction(MI).Methods The patients with CHF after MI(n=304)were chosen from West District of Qingdao Municipal Hospital from Jan.2019 to Jan.2020.The observation indexes included the comparison in clinical characteristics in patients with different heart function grades,relationship among sST2,Gal-3 and prognosis and predictive efficacy of sST2 and Gal-3 in reviewing prognosis.The patients were divided,according to outcomes,into death group,exacerbation group and non-abnormal group.Results The levels of serum sST2 and Gal-3 increased gradually and LVEF level decreased gradually with the increase of heart function grading(P<0.05).There were significant differences in sST2 and Gal-3 among death group,exacerbation group and non-abnormal group.The levels of serum sST2 and Gal-3 were significantly higher in death group than those in exacerbation group and non-abnormal group,and were significantly higher in exacerbation group than those in non-abnormal group(P<0.05).When sST2 level was more than 32.85 ng/ml and Gal-3 level was more than 16.78 ng/ml,they were the predictive factors of CHF exacerbation,and when sST2 level was more than 46.14 ng/ml and Gal-3 level was more than 22.01 ng/ml,they were the predictive factors of death in CHF patients.The total survival rate was significantly lower in high-expressed sST2 group than that in low-expressed sST2 group,and was significantly lower in high-expressed Gal-3 group than that in low-expressed Gal-3 group.Conclusion The levels of serum sST2 and Gal-3 can effectively predict the exacerbation and prognosis outcomes of cardiac events in CHD patients,and combination of sST2 and Gal-3 has some reference value to CHF diagnosis and prognosis prediction.