慢性心力衰竭患者血清CA125 GDF15 sTREM-1水平及其与心功能的相关性分析

Serum Levels of Carbohydrate Antigen 125(CA125)Growth Differentiation Factor-15(GDF-15)and Soluble Triggering Receptor Expressed on Myeloid Cells-1(sTREM-1)in Patients with Chronic Heart Failure and their Correlation with Cardiac Function:An Analysis

目的:探究血清糖类抗原125(CA125)、生长分化因子-15(GDF-15)、可溶性髓样细胞触发受体-1(sTREM-1)在慢性心力衰竭患者中的表达及其与心功能的相关性分析。方法:选取2022年6月至2023年6月本院收治的CHF患者96例临床资料开展回顾性分析,其中轻中度心力衰竭组46例(NYHA分级为Ⅰ~Ⅲ级)、重度心力衰竭组50例(NYHA分级为Ⅳ级),另按2∶1比例选取同期本院检查健康体检者48名为健康对照组。比较各组血清CA125、GDF15、sTREM-1水平与心功能指标的差异,并分析血清CA125、GDF15、sTREM-1水平与心功能指标的相关性。并通过ROC曲线分析血清CA125、GDF15、sTREM-1水平诊断慢性心力衰竭的效能。结果:研究组CA125、GDF15、sTREM-1水平均高于对照组(P<0.05)。研究组FS、EF均低于对照组,LAD、LVEDD均高于对照组(P<0.05)。Person相关性分析显示,CA125、GDF15、sTREM-1均与FS、EF呈负相关(r=-0.605/-0.617、-0.516/-0.512、-0.572/-0.613,P<0.05),均与LAD、LVEDD呈正相关(r=0.827/0.818、0.819/0.834、0.846/0.878,P<0.05)。重度心力衰竭组CA125、GDF15、sTREM-1水平均高于轻中度心力衰竭组(P<0.05)。二元Logistic回归分析显示,血清CA125、GDF15、sTREM-1为重度心力衰竭的危险因素(P<0.05)。采用ROC分析血清CA125、GDF15、sTREM-1评估慢性心力衰竭严重程度的AUC、敏感度、特异度,分别为0.761、0.695、0.822,以预测评分绘制ROC曲线评估慢性心力衰竭严重程度的AUC为0.848,敏感度为84.0%、特异性为82.6%。结论:血清CA125、GDF15、sTREM-1在CHF患者中高表达,与心功能相关密切,可作为评估心力衰竭严重程度的有效指标,联合评估效果更好。

Objective:To explore the expression of serum carbohydrate antigen 125(CA125),growth differentiation factor-15(GDF-15)and soluble myeloid cell trigger receptor-1(sTREM-1)in patients with chronic heart failure and their correlation with cardiac function.Methods:The clinical data of 96 patients with CHF admitted to our hospital from June 2022 to June 2023 were analyzed retrospectively,including 46 patients with mild and moderate heart failure(NYHA gradeⅠ-Ⅲ)and 50 patients with severe heart failure(NYHA gradeⅣ).In addition,48 healthy people who underwent physical examination in our hospital during the same period were selected as the healthy control group according to the ratio of 2:1.The serum levels of CA125,GDF15 and sTREM-1 were compared with the cardiac function indexes,and the correlation between the serum levels of CA125,GDF15 and sTREM-1 and the cardiac function indexes was analyzed.The ROC curve was used to analyze the efficacy of serum levels of CA125,GDF15 and sTREM-1 in diagnosing chronic heart failure.Results:The levels of CA125,GDF15,and sTREM-1 in the study group were higher than those in the control group(P<0.05).FS and EF in the study group were lower than those in the control group,while LAD and LVEDD were higher than those in the control group(P<0.05).Person correlation analysis showed that CA125,GDF15,and sTREM-1 were negatively correlated with FS and EF(r=-0.605/-0.617,-0.516/-0.512,-0.572/-0.613,P<0.05),and positively correlated with LAD and LVEDD(r=0.827/0.818,0.819/0.834,0.846/0.878,P<0.05).The levels of CA125,GDF15,and sTREM-1 in the severe heart failure group were higher than those in the mild to moderate heart failure group(P<0.05).Binary Logistic Regression Analysis showed that serum CA125,GDF15,and sTREM-1 were risk factors for severe heart failure(P<0.05).The AUC,sensitivity,and specificity of serum CA125,GDF15,and sTREM-1 in evaluating the severity of chronic heart failure were 0.761,0.695,and 0.822,respectively.The AUC for assessing the severity of chronic heart failure by prediction scoring ROC curves was 0.848 with a sensitivity of 84.0%and a specificity of 82.6%.Conclusion:Serum levels of CA125,GDF15,and sTREM-1 are upregulated in patients with CHF and are closely related to cardiac function.They can be used as effective indicators to evaluate the severity of heart failure,with better combined evaluation performance.