生长刺激表达基因2蛋白和NLR在尿毒症所致肾源性心力衰竭中的表达及临床意义  

Expression and clinical significance of soluble suppression of tumorigenicity 2 and NLR in nephrogenic heart failure caused by uremia

作　　者：王磊 尤洪兰 刘芳 于农 WANG Lei;YOU Hong⁃lan;LIU Fang;YU Nong(Department of Laboratory Medicine,People's Hospital of Suzhou High⁃tech Zone,Suzhou,Jiangsu 215011,China)

机构地区：[1]苏州高新区人民医院检验科,江苏苏州215011

出　　处：《热带医学杂志》2022年第12期1715-1718,共4页Journal of Tropical Medicine

基　　金：重大前沿原创技术成果转化和产业化项目(SGY-H202002)

摘　　要：目的探究生长刺激表达基因2蛋白(sST2)和中性粒细胞与淋巴细胞比值(NLR)在尿毒症所致肾源性心力衰竭不同病程的表达差异,并分析其对病情评估的价值。方法选取2020年1月-2021年12月苏州高新区人民医院的尿毒症患者126例为研究对象,根据患者是否发生心力衰竭分为尿毒症合并心力衰竭组(简称尿毒症合并心衰组)(n=45)和尿毒症组(n=81)。采用微点I200干式荧光免疫分析仪测定两组患者尿素氮(BUN)、肌酐(Cr)、NLR,人sST2酶联免疫分析试剂盒检测血清sST2水平,比较两组BUN、Cr、NLR、sST2水平,绘制受试者工作特征(ROC)曲线分析sST2、NLR对尿毒症合并心力衰竭患者的诊断价值。结果尿毒症合并心衰组NLR、sST2、BUN水平均高于尿毒症组,差异均有统计学意义(t=6.642、6.194、4.963,P均<0.05)。多因素logistic回归分析显示,sST2(β=0.756,OR=2.130)、NLR(β=1.383,OR=3.987)是尿毒症患者发生肾源性心力衰竭的独立影响因素(P<0.05)。ROC曲线显示,NLR、sST2联合检测诊断尿毒症所致肾源性心力衰竭的曲线下面积(AUC)为0.879,敏感性、特异性分别为88.9%、92.6%,优于单一检测(P<0.05)。结论sST2、NLR随着病情加重逐渐升高,在尿毒症所致肾源性心力衰竭早期病情评估中有重要的临床价值。Objective Explore the expression differences of soluble suppression of tumorigenicity 2(sST2)and neutrophil to lymphocyte ratio(NLR)in different courses of nephrogenic heart failure caused by uremia,and analyze its value for disease assessment.Methods From January 2020 to December 2021,126 patients with uremia in the People’s Hospital of Suzhou High-tech Zone were selected as the research objects.According to whether the patients had heart failure or not,they were divided into uremic combined heart failure group(n=45)and uremia group(n=81).Urea nitrogen(BUN),creatinine(Cr)and NLR levels were measured by micro-spot I200 dry fluorescence immunoassay analyzer,and serum sST2was detected by human sST2 enzyme-linked immunosorbent assay kit.The BUN,Cr,NLR and sST2 levels were compared between the two groups.The diagnostic values of sST2 and NLR in patients with uremia complicated with heart failure were analyzed by receiver operating characteristic(ROC)curve.Results The levels of NLR,sST2,BUN in the uremia combined with heart failure group were higher than those in the uremia group,and the differences were statistically significant(t=6.642,6.194,4.963,P all<0.05).Multivariate logistic regression analysis showed that sST2(β=0.756,OR=2.130)and NLR(β=1.383,OR=3.987)were independent influencing factors of nephrogenic heart failure in uremic patients(P<0.05).The ROC curve showed that the combined detection of NLR and sST2 had an area under curve(AUC)of 0.879for diagnosing nephrogenic heart failure caused by uremia,with a sensitivity and specificity of 88.9%and 92.6%,respectively,which were better than single detection(P<0.05).Conclusion sST2 and NLR gradually increased with the aggravation of the disease,which had important clinical value in the early evaluation of nephrogenic heart failure caused by uremia.

关 键 词：生长刺激表达基因2蛋白 中性粒细胞与淋巴细胞比值 尿毒症 心力衰竭 

分 类 号：R692[医药卫生—泌尿科学] R541.6[医药卫生—外科学]