肺心病患者Gal-3、fetuin-A表达及与病情相关性分析

Expressions of Gal-3 and Fetuin-A in Patients with Pulmonary Heart Disease and Their Correlations with the Disease

目的探讨肺源性心脏病患者血清半乳糖凝集素-3(Gal-3)、胎球蛋白A(fetuin-A)表达情况及其与病情相关性。方法将2020年4月至2022年4月于本院进行诊治的150例肺源性心脏病患者纳入研究,依据病情严重程度分为代偿组及失代偿组,每组患者75例,且依据不同预后情况分为存活组(n=100)及死亡组(n=50),另选取同期于本院进行健康体检的75名健康者作为对照组;分析对照组、代偿组及失代偿组Gal-3、fetuin-A水平;采用ROC曲线分析Gal-3、fetuin-A及联合检测对肺源性心脏病的诊断价值;采用多因素Logistic回归分析影响患者预后的危险因素。结果对照组Gal-3表达水平显著低于代偿组及失代偿组,且失代偿组Gal-3水平最高;对照组fetuin-A水平较代偿组及失代偿组更高,且失代偿组fetuin-A水平最低(均P<0.05)。Gal-3、fetuin-A对肺源性心脏病具有一定的诊断价值,但联合检测诊断特异性及灵敏度更高,AUC分别为0.555(0.472~0.636)、0.755(0.679~0.822)、0.875(0.812~0.924);吸烟史、脑钠肽(BNP)、Gal-3均为患者预后不良的独立危险因素,fetuin-A为患者预后不良的独立保护因素(P<0.05)。结论Gal-3、fetuin-A对肺源性心脏病具有一定诊断价值,但联合检测灵敏度及特异性更高,值得临床推广应用;且吸烟史、BNP、Gal-3、fetuin-A与患者预后具有显著相关性。

Objective To investigate expressions of serum galectin-3(Gal-3)and fetuin-A in patients with pulmonary heart disease and their correlations with the disease.Methods A total of 150 patients with pulmonary heart disease diagnosed and treated in our hospital from April,2020 to April,2022 were included in the study.These patients were divided into a compensatory group and a decompensated group according to the severity of the disease,with 75 patients in each group,and also divided into a survival group(n=100)and a death group(n=50)according to different prognosis.Another 75 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group.Levels of Gal-3 and fetuin-A in the control group,compensated group and decompensated group were analyzed.ROC curve was drawn to evaluate the diagnostic value of Gal-3,fetuin-A and combined detection in pulmonary heart disease.Multivariate logistic regression was used to analyze the risk factors affecting the prognosis of patients.Results The expression level of Gal-3 in the control group was significantly lower than that in the compensatory group and the decompensated group,and the level of Gal-3 in the decompensated group was the highest.The level of fetuin-A in the control group was higher than that in the compensated and decompensated groups,and the level of fetuin-A in the decompensated group was the lowest(all P<0.05).Gal-3 and fetuin-A showed certain diagnostic value for pulmonary heart disease,but the diagnostic specificity and sensitivity of combined detection were higher,with AUC values of 0.555(0.472-0.636),0.755(0.679-0.822)and 0.875(0.812-0.924),respectively.Smoking history,brain natriuretic peptide(BNP)and Gal-3 were independent risk factors for the poor prognosis,and fetuin-A was an independent protective factor for the poor prognosis(P<0.05).Conclusion Gal-3 and fetuin-A have certain diagnostic value for pulmonary heart disease,but the sensitivity and specificity of combined detection are higher,suggesting that it is worthy of clinical application.Smoking history,BNP,Gal-3 and fetuin-A are significantly correlated with the prognosis of patients.