LVEF正常的心衰患者血清Lp(a)和TSP-2联合检测的临床意义  

Diagnosis value of joint detection of serum levels of lipoprotein A and platelet adsorption protein 2 for heart failure and normal ejection fraction

作　　者：陈永华 谷欣[2] 

机构地区：[1]惠州市惠城区水口人民医院急诊内科,广东惠州516005 [2]惠州市第三人民医院ICU,广东惠州516000

出　　处：《热带医学杂志》2016年第5期646-649,共4页Journal of Tropical Medicine

摘　　要：目的探讨联合检测射血分数(LVEF)正常性心力衰竭患者血清脂蛋白a[Lp(a)]和血小板吸附蛋白2(TSP-2)水平的临床意义。方法选取LVEF正常(LVEF≥50%)的慢性心力衰竭(CHF)患者68例为CHF组,另选取30名同期健康查体志愿者为对照组。采用ELISA法检测对照组和CHF组治疗前后的血清Lp(a)和TSP-2水平,统计其1年的生存情况,比较不同预后情况患者治疗前后的血清Lp(a)和TSP-2水平,分析LVEF正常性CHF患者血清Lp(a)和TSP-2水平与其1年生存率的关系及两者联合预测其1年生存率的价值。结果与对照组比较,CHF组治疗前的血清Lp(a)和TSP-2水平均升高;与治疗前比较,CHF组治疗3 d、7 d和10 d的血清Lp(a)和TSP-2水平降低(P<0.05)。CHF组1年生存率为82.35%,且存活患者治疗前后的血清Lp(a)和TSP-2水平均低于死亡患者(P<0.05)。Spearman无条件相关分析结果显示,LVEF正常性CHF患者血清Lp(a)和TSP-2水平与其1年生存率均呈负相关(r=-0.752,-0.768,P<0.05)。ROC曲线分析结果显示,LVEF正常性CHF患者血清Lp(a)和TSP-2水平联合预测其1年生存率的敏感度、特异度、准确性、阳性预测值和阴性预测值分别为98.21%、91.67%、97.06%、98.21%和91.67%,LVEF正常性CHF患者血清Lp(a)和TSP-2水平联合预测其预后的价值较高。结论血清Lp(a)和TSP-2水平联合预测LVEF正常性CHF患者预后的价值良好,可能作为其预后评估的参考指标。Objective To explore the diagnosis value of joint detection of serum levels of lipoprotein A（Lp A） and platelet adsorption protein 2（TSP-2）for heart failure and normal ejection fraction（LVEF）. Methods 68 cases of patients with chronic heart failure（CHF） and normal LVEF（LVEF ≥ 50%） were selected as CHF group, and other 30 cases of healthy volunteers who had physical exam in the same period were selected as control group. ELISA method was applied to detect serum Lp A and TSP-2 levels. 1 year survival rate were calculated. Before and after treatment serum Lp A and TSP-2 levels of patients with different prognosis were compared. The relationship between serum Lp A and TSP-2 levels of CHF patients with normal LVEF with 1 year survival rate was analyzed, and the value of predicting the 1 year survival rate was analyzed. Results Compared with control group, serum Lp A and TSP-2 levels of CHF group before and after treatment were higher in the CHF group. Serum levels of Lp A and TSP-2 of CHF group were lowered after treated for 3 d, 7 d and 10 d（P〈0.05）. 1 year survival rate of CHF group was 82.35%, and the serum levels of Lp A and TSP-2 of survived patients before and after treatment were lower than those of the death patients（P 〈0.05）.Unconditional Spearman correlation analysis results showed that serum Lp A and TSP-2 levels of CHF patients with normal LVEF and the 1 year survival rates were negatively correlated（r=-0.752,-0.768, P〈0.05）. ROC curve analysis showed that sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the joint detection of serum levels of Lp A and TSP-2 were 98.21%,91.67%,97.06%,98.21% and 91.67%, respectively.Conclusion Diagnosis value of serum Lp A and TSP-2 levels predicting prognosis of CHF patients with normal LVEF is good,Therefore, these two factors could be a reference index for the prognostic evaluation.

关 键 词：射血分数正常 心力衰竭 脂蛋白A 血小板吸附蛋白2 

分 类 号：R541.6[医药卫生—心血管疾病]