硫氧还蛋白1与急性心力衰竭患者预后的相关性研究

Correlation Between Thioredoxin 1 and Prognosis of Patients with Acute Heart Failure

目的 探讨硫氧还蛋白1(thioredoxin 1,Trx-1)预测急性心力衰竭(acute heart failure,AHF)患者预后的临床价值。方法 选取2014-01/2018-12月因AHF发作在作者医院心内科住院的317例患者作为研究对象。采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)测定患者血清Trx-1水平,并进行为其1年的随访。分析Trx-1对AHF患者长期预后的影响。结果 根据是否发生终点事件,将患者分为死亡组和生存组,死亡组患者Trx-1水平显著高于生存组患者,差异有统计学意义(11.78±2.13 vs.8.73±1.87,t=3.325,P=0.001)。受试者工作特征(receiver operating characteristic,ROC)曲线表明,Trx-1预测AHF患者发生不良结局的曲线下面积(area under the curve,AUC)为0.809 (95%CI:0.760~0.851),截断值为11.82 ng/ml,敏感度为53.72%,特异度为93.24%。多因素Cox回归显示,Trx-1升高是AHF患者1年死亡的独立危险因素(HR=1.56,95%CI:1.36~1.78,P<0.001)。结论 Trx-1可作为评估AHF患者长期预后的一种新的生物标志物,指导临床实践。

Objective To investigate the clinical value of thioredoxin 1(Trx-1) in predicting the prognosis of patients with acute heart failure(AHF).Methods A total of 317 patients who were hospitalized in the department of cardiology because of AHF attack in author′s hospital from January 2014 to December 2018 were selected as study subjects.The level of serum Trx-1 was detected by enzyme-linked immunosorbent assay(ELISA) and each patients were follow-up for 1 year.The effects of Trx-1 on the long-term prognosis of patients with AHF were analyzed.Results The patients were divided into death group and survival group according to the occurrence of endpoint events.The patients in death group had a significantly higher Trx-1 level than that in the survival group(11.78±2.13 vs.8.73±1.87,t=3.325,P=0.001).The receiver operating characteristic(ROC) curve showed that the area under the curve(AUC) of Trx-1 predicting adverse outcomes in AHF patients was 0.809(95% CI:0.760-0.851),the cutoff was 11.82 ng/ml,the sensitivity was 53.72% and the specificity was 93.24%.Multivariate Cox regression showed that elevated Trx-1 was an independent risk factor for one-year death in patients with AHF(HR=1.56,95% CI:1.36-1.78;P<0.001).Conclusion Trx-1 can be used as a new biomarker to evaluate the long-term prognosis of patients with AHF and in can direct clinical practice.