PCSK6联合脑钠肽在肾功能不全合并心力衰竭中的应用价值

Application value of PCSK6 combined with BNP in renal insufficiency complicated with heart failure

目的探讨前蛋白转化酶枯草溶菌素6(proprotein converting enzyme subtilysin 6,PCSK6)在慢性肾功能不全(CRI)合并心力衰竭(HF)中的表达水平,PCSK6和脑钠肽(brain natriuretic peptide,BNP)联合诊断在CRI合并HF中的应用价值。方法选取2023年6月1日至2024年1月31日于河南省两家三甲医院肾内科住院的慢性肾功能不全(CRI)患者129例,其中单纯CRI患者53例,HF患者76例。收集患者一般临床资料、BNP、肌酐、尿素氮、尿酸、胱抑素C、肾小球滤过率(eGFR)等检测指标和左心室射血分数、E/A值、室间隔厚度、左心室后壁厚度等心功能参数,采用ELISA方法比较两组血清PCSK6的浓度。采用Spearman相关性分析血清PCSK6与BNP的相关性。ROC曲线分析血清PCSK6和BNP联合诊断对CRI合并HF的预测价值。结果CRI合并HF组PCSK6、BNP等均高于单纯CRI组,且差异有统计学意义(P<0.05)。根据Spearman相关分析结果,血清PCSK6与BNP成正相关(r=0.440,P<0.001)。经ROC曲线分析,血清PCSK6联合BNP诊断CRI合并HF的AUC为0.884,高于PCSK6(AUC=0.822)、BNP(AUC=0.835)。结论血清PCSK6与BNP相关。血清PCSK6联合BNP对于CRI合并HF的诊断具有很好的预测价值,血清PCSK6有望成为CRI合并HF的新型标志物。

Objective To investigate the expression level of proprotein converting enzyme subtilysin 6(PCSK6)in chronic renal insufficiency(CRI)complicated with heart failure(HF),and the value of the combined diagnosis of PCSK6 and brain natriuretic peptide(BNP)in CRI complicated with HF.Methods A total of 129 patients with CRI who were hospitalized in the renal department of two 3A grade hospitals in Henan Province from June 1,2023 to January 31,2024 were selected,including 53 patients with simple CRI and 76 patients with heart failure(HF).General clinical data,BNP,creatinine,urea,uric acid,cystatin C,glomerular filtration rate(eGFR)and other laboratory test indicators,left ventricular ejection fraction,E/A value,ventricular septal thickness,left ventricular posterior wall thickness,and other cardiac function parameters were collected.The serum PCSK6 concentration of the two groups was compared by ELISA.The correlation between serum PCSK6 and BNP was analyzed by Spearman correlation.ROC curve analysis of the diagnosis of serum PCSK6 combined with BNP in the prediction of CRI combined with HF.Results PCSK6 and BNP in HF group with CRI were higher than those in simple CRI group,and the difference was statistically significant(P<0.05).According to Spearman correlation analysis,serum PCSK6 was positively correlated with BNP(r=0.440,P<0.001).According to ROC curve analysis,the AUC of serum PCSK6 combined with BNP in the diagnosis of CRI combined with HF was 0.884,higher than that of PCSK6(AUC=0.822)and BNP(AUC=0.835).Conclusion Serum PCSK6 is related to BNP.Serum PCSK6 combined with BNP has a good predictive value for the diagnosis of CRI combined with HF,and serum PCSK6 is expected to be a new marker of CRI combined with HF.