慢性心力衰竭患者血清sFGL2、AFABP与心力衰竭严重程度及预后的相关性研究

Correlation between serum sFGL2,AFABP and the severity and prognosis of patients with chronic heart failure

目的探究慢性心力衰竭患者血清可溶性纤维蛋白原2(sFGL2)、脂肪细胞型脂肪酸结合蛋白(AFABP)与心力衰竭严重程度及预后的相关性研究。方法选取2020年6月至2022年6月于唐山市人民医院(下称该院)治疗的102例确诊的慢性心力衰竭患者为患病组,根据病情严重程度分为Ⅱ级组(28例)、Ⅲ级组(35例)和Ⅳ级组(39例),根据预后是否出现不良心血管事件(MACE)进行分组,分为MACE组(44例)和无MACE组(58例),另选取102例同期于该院体检的健康者为对照组。比较各组血清sFGL2、AFABP的水平;Logistic回归分析患者发生预后不良的影响因素;受试者工作特征(ROC)曲线分析血清sFGL2、AFABP水平对患者发生预后不良的预测价值。结果与对照组相比,患病组血清sFGL2水平显著降低(P<0.05),AFABP水平显著升高(P<0.05);Ⅱ级组、Ⅲ级组、Ⅳ级组血清sFGL2水平依次降低(P<0.05),AFABP水平依次升高(P<0.05);MACE组的心率、sFGL2水平显著低于无MACE组(P<0.05),心房颤动占比、AFABP水平显著高于无MACE组(P<0.05);心率、心房颤动、AFABP为患者发生MACE的独立危险因素(P<0.05),sFGL2为患者发生MACE的独立保护因素(P<0.05);血清sFGL2、AFABP预测患者发生MACE的曲线下面积(AUC)分别为0.842、0.858,二者联合预测的AUC为0.943,二者联合预测优于各自单独预测(Z二者联合-sFGL2=2.898,P=0.004;Z二者联合-AFABP=2.608,P=0.009)。结论慢性心力衰竭患者血清sFGL2水平下调,AFABP水平上调,且为患者发生MACE的影响因素,二者联合预测患者预后具有更高效能。

Objective To investigate the correlation between serum soluble fibrinogen like protein 2(sFGL2)and adipocyte fatty acid-binding protein(AFABP)with the severity and prognosis of patients with chronic heart failure.Methods A total of 102 confirmed chronic heart failure patients treated in Tangshan People′s Hospital(the hospital)from June 2020 to June 2022 were regarded as the disease group.They were divided into gradeⅡgroup(28 cases),gradeⅢgroup(35 cases),and gradeⅣgroup(39 cases)based on their illness severity.They were separated into MACE group(44 cases)and non MACE group(58 cases)based on their prognosis.Additionally,102 healthy individuals who came to Tangshan People′s Hospital for physical examination were regarded as the control group.The levels of serum sFGL2 and AFABP in each group were compared.Logistic regression was applied to analyze the influencing factors of poor prognosis in patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum sFGL2 and AFABP levels for poor prognosis in patients.Results Compared with the control group,the serum sFGL2 level in the diseased group was greatly reduced(P<0.05),while the AFABP level was greatly increased(P<0.05).The serum sFGL2 level in gradeⅡgroup,gradeⅢgroup,and gradeⅣgroup decreased sequentially(P<0.05),while the AFABP level increased sequentially(P<0.05).The heart rate and sFGL2 level in the MACE group were greatly lower than those in the non MACE group(P<0.05),while the proportion of atrial fibrillation and AFABP level were greatly higher than those in the non MACE group(P<0.05).Heart rate,atrial fibrillation,and AFABP were independent risk factors for MACE in patients(P<0.05),while sFGL2 was an independent protective factor for MACE in patients(P<0.05).The area under the curve(AUC)of serum sFGL2 and AFABP for predicting MACE in patients was 0.842 and 0.858,respectively,the AUC of the combination of the two was 0.943,and the combined prediction of the two was better than the individual prediction(Z combined prediction-sFGL2=2.898,P=0.004;Z combined prediction-AFABP=2.608,P=0.009).Conclusion Serum sFGL2 level is down regulated and AFABP level is up regulated in patients with chronic heart failure,which are influencing factors for the occurrence of MACE.The combination of the two has higher efficacy in predicting the prognosis of the patients.