血清肌钙蛋白I、内皮素-1联合缺氧诱导因子-1α对心力衰竭预测价值

Predictive value of serum troponin I,and endothelin-1 combined with hypoxia inducible factor-1αfor heart failure

目的探讨血清肌钙蛋白I(cTnI)、内皮素-1(ET-1)联合缺氧诱导因子-1α(HIF-1α)对心力衰竭(下称心衰)的预测价值。方法选择2018年3月至2020年2月郑州市第七人民医院收治的肺动脉高压(PH)患者117例,根据随访12个月期间患者是否发生射血分数保留型(EF)心衰分为PH心衰组和PH组。检测并比较两组患者的血清cTnI、ET-1、HIF-1α水平。采用多因素Cox比例风险回归分析法分析心衰的影响因素,采用ROC曲线评估血清cTnI、ET-1联合HIF-1α对心衰的预测价值。结果两组在PH严重程度差异有统计学意义(P<0.05)。PH心衰组血清cTnI、ET-1、HIF-1α水平均高于PH组(均P<0.05)。血清cTnI、ET-1、HIF-1α水平升高、PH严重程度,均是心衰的危险因素(均P<0.05)。与血清cTnI、ET-1、HIF-1α各单项指标预测结果相比,三项指标联合在心衰预测的特异度、AUC均明显占优(均P<0.05)。血清cTnI、ET-1、HIF-1α联合预测心衰的灵敏度与各指标单独预测灵敏度,差异均无统计学意义(均P>0.05)。结论血清cTnI、ET-1、HIF-1α水平表达增高均可增加心衰发生风险,上述指标对PH并发EF心衰的发生均有预测价值,三项联合时的预测价值更高。

Objective To study the predictive value of the combination of serum troponin I(cTnI),endothelin-1(ET-1)and hypoxia inducible factor-1α(HIF-1α)for heart failure(HF).Methods One hundred and seventeen patients with pulmonary hypertension admitted to No.7 People’s Hospital of Zhengzhou from March 2018to February 2020 were selected and divided into pulmonary hypertension heart failure group and pulmonary hypertension group according to whether HF with preserved ejection fraction was found during the 12-month follow-up.Serum cTnI,ET-1 and HIF-1 of the two groups were detected and compared.Multivariate Cox proportional hazard regression analysis was used to analyze the influencing factors of HF,and ROC curve was used to evaluate the predictive value of serum cTnI,ET-1 and HIF-1αfor HF.Results The difference in PH severity between the two groups was statistically significant(P<0.05).Serum cTnI,ET-1,HIF-1 in PH heart failure groupαThe levels were higher than those in PH group(all P<0.05).Serum cTnI,ET-1,HIF-1αElevated level and severity of PH were risk factors for heart failure(all P<0.05).And serum cTnI,ET-1,HIF-1αCompared with the prediction results of each single index,the specificity and AUC of the combination of the three indexes in predicting heart failure were significantly superior(all P<0.05).Serum cTnI,ET-1,HIF-1αThere was no significant difference between the sensitivity of combined prediction of heart failure and that of each index alone(P>0.05).Conclusion Increased expression of serum cTnI,ET-1,and HIF-1αwould increase the risk of HF.Serum cTnI,ET-1,and HIF-1αhave predictive value for the occurrence of pulmonary hypertension and HF with preserved emission blood fraction,and the predictive value is higher when the three factors are combined.