血清PD-1、Lp-PLA2水平与慢性心力衰竭患者米力农治疗预后的关系研究

Study on the relationship between PD-1,Lp-PLA2 levels in the serum and the prognosis of milrinone treatment in patients with chronic heart failure

目的观察慢性心力衰竭(CHF)患者米力农治疗预后与血清细胞程序性死亡受体-1(PD-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平的关系。方法选取2019年1月至2020年6月在淄博市中心医院接受米力农治疗的140例CHF患者,所有患者均治疗至出院,经治疗随访至结束(2021年5月),统计复发(再入院治疗)、病死情况,根据结果分为不良组(病死、复发)与良好组,分析血清PD-1、Lp-PLA2水平与CHF患者米力农治疗预后的关系。结果140例CHF患者预后不良21例,预后良好119例。不良组患者的左室射血分数(LVEF)低于良好组,PD-1、Lp-PLA2水平高于良好组(P<0.05);经COX分析结果显示,血清PD-1、Lp-PLA2过表达、LVEF低可能是CHF患者米力农治疗预后不良的危险因素(P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,CHF患者治疗前血清PD-1、Lp-PLA2预测米力农治疗预后不良风险的AUC均>0.70。结论血清PD-1、Lp-PLA2异常表达可能与CHF患者米力农治疗预后不良有关。

Objective To investigate the relationship between the prognosis of milrinone treatment and programmed cell death protein 1(PD-1)and lipoprotein-associated phospholipase A2(Lp-PLA2)in the serum of patients with chronic heart failure(CHF).Methods A total of 140 patients with CHF who received milrinone treatment in ZiBo Central Hospital from January 2019 to June 2020 were selected.All patients were treated until discharge and were followed up to the end of treatment(May 2021).Recurrence(re-admission treatment)and mortality were analyzed.According to the analysis results,the patients were divided into the poor group(death,recurrence)and the good group.The relationship between PD-1 and Lp-PLA2 levels in the serum,and the prognosis of milrinone treatment in patients with chronic heart failure was analyzed.Results Among 140 patients with CHF,21 had a poor prognosis and 119 had a good prognosis.The left ventricular ejection fraction(LVEF)of patients in the poor group was lower than that in the good group,and the levels of PD-1 and Lp-PLA2 were higher than those in the good group(P<0.05).Cox analysis showed that overexpression of PD-1 and Lp-PLA2 in the serum,and low LVEF may be the risk factors for poor prognosis in patients with CHF after milrinone treatment(P<0.05).The receiver operating characteristic curve(ROC curve)was plotted,and the results showed that the AUC of PD-1 and Lp-PLA2 in the serum of patients with CHF before treatment to predict the risk of poor prognosis after milrinone treatment was>0.70.Conclusion The abnormal expression of PD-1 and Lp-PLA2 in serum may be related to the poor prognosis of patients with CHF treated with milrinone.