血清S100A4、S100A9、P-selectin在心力衰竭患者中的表达及与预后的相关性

Expression of serum S100A4,S100A9 and P-selectin in patients with heart failure and their correlations with prognosis

目的 探讨血清钙结合蛋白A4(S100A4)、血清钙结合蛋白A9(S100A9)、P-选择素(P-selectin)在心力衰竭(简称心衰)患者中的表达情况及其与预后的相关性。方法 选择2017年9月至2021年2月西安市儿童医院心内科收治的心衰患者92例作为心衰组,同期选择在该院体检中心经询问病史及检查证实的除外心衰的体检者92例作为对照组。检测两组血清S100A4、S100A9、P-selectin表达水平,随访心衰患者预后情况,并分析S100A4、S100A9、P-selectin水平与预后的相关性。采用受试者工作特征(ROC)曲线及各指标对预后不良的预测价值,采用Cox比例风险回归模型分析心衰患者预后的影响因素。结果 心衰组血清S100A4、S100A9水平低于对照组,血清P-selectin水平高于对照组,差异均有统计学意义(P<0.05)。随访6个月,心衰组患者预后不良10例,发生率为10.9%。Spearman分析显示,预后不良与S100A4、S100A9、P-selectin水平存在相关性(P<0.001)。S100A4、S100A9、P-selectin及三者联合预测心衰预后不良的ROC曲线下面积(AUC)分别为0.686、0.697、0.672和0.718。Cox比例风险回归模型分析显示,S100A4、S100A9、P-selectin均为心衰患者预后的影响因素(P<0.05)。结论 心衰患者多伴随有血清S100A4、S100A9的高表达与P-selectin的低表达,与心衰患者的预后存在相关性,可有效预测患者预后情况。

Objective To investigate the expression of serum calcium-binding protein A4(S100 A4),serum calcium-binding protein A9(S100 A9) and P-selectin in patients with heart failure and their correlations with prognosis.Methods From September 2017 to February 2021,92 patients with heart failure admitted to the Department of Cardiology of Xi ′an Children′s Hospital were selected as the heart failure group.At the same time,92 subjects except for heart failure confirmed by medical history and examination in the Physical Examination Center of the hospital were selected as the control group.Serum S100 A4,S100 A9 and P-selectin levels were detected in the two groups,the prognosis of patients with heart failure was followed up,and the correlations between S100 A4,S100 A9 and P-Selectin levels and prognosis were analyzed.Receiver operating characteristic(ROC) curve was used to analyze the predictive value of each index for poor prognosis.Moreover,Cox proportional risk regression model was used to analyze the influencing factors for prognosis of heart failure patients.Results The serum S100 A4 and S100 A9 levels in heart failure group were lower than those in control group,and the serum P-selectin level was higher than that in control group,with statistical significance(P<0.05).After 6 months of follow-up,10 patients in heart failure group had poor prognosis,and the incidence was 10.9%.Spearman analysis showed that poor prognosis correlated with S100 A4,S100 A9 and P-selectin levels(P<0.001).The area under ROC curve(AUC) of S100 A4,S100 A9,P-selectin and their combination in predicting poor prognosis of heart failure were 0.686,0.697,0.672 and 0.718 respectively.Cox proportional risk regression model analysis showed that S100 A4,S100 A9 and P-selectin were main factors affecting the prognosis of patients with heart failure(P<0.05).Conclusion The high expression of S100 A4 and S100 A9 and the low expression of P-selectin associated with the prognosis of patients with heart failure,which could effectively predict the prognosis of patients.