血清CysC及NHE1 mRNA水平检测在心力衰竭诊断中的临床应用  

Clinical Application of Serum CysC Level and NHE1 mRNA Level in the Diagnosis of Heart Failure

作　　者：陈蓉 陆爱民 张晓春 CHEN Rong;LU Ai-min;ZHANG Xiao-chun(Department of Coronary Heart Disease,Qinghai Cardiovascular and Cerebrovascular Disease Hospital,Xining 810000,China)

机构地区：[1]青海省心脑血管病专科医院冠心病二科,青海西宁810000

出　　处：《标记免疫分析与临床》2019年第2期281-284,298,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨血清CysC(cystatin C,CysC)和血浆钠氢交换体1(sodium-hydrogen exchanger 1,NHE1)mRNA水平二者联合检测在心力衰竭(heartfailure,HF)早期诊断中的临床意义。方法血清CysC用ELISA检测,血浆NHE1 mRNA用荧光定量PCR检测。检测97例明确诊断为HF患者(病例组I),40例经诊断未有HF的冠心病、高血压等其他患者(病例组II),45例健康体检人群(对照组)的CysC及NHE1 mRNA的水平。分析三组受试者的血液中CysC及NHE1 mRNA水平差异,及两项指标联合检测的诊断心衰的临床价值。结果病例I组中血清CysC水平及血浆NHE1 mRNA水平分别为1.67±0. 27mg/L和1. 38±0. 21,病例II组CysC水平及NHE1 mRNA水平分别为1.25±0.28mg/L和1.09±0.19,对照组CysC水平及NHE1 mRNA水平分别为0.89±0. 1Omg/L和0.89±0.25,各组两两比较差异均有统计学意义(P均<0.05);联合检测平行(并联)试验对心力衰竭诊断的灵敏度和特异性分别为94. 85%和87.06%,优于单独检测CysC指标的灵敏度(88.66%)和特异性(91.76%)或NHE1 mRNA指标的灵敏度(63.92%)和特异性(95.29%)。结论联合检测CysC和NHE1 mRNA对心力衰竭的早期筛查和诊断具有一定的临床应用价值。Objective To investigate the clinical significance of combined detection of serum Cystatin C(CysC)level and plasma sodium-hydrogen exchanger 1(NHE1)mRNA level in the early diagnosis of heart failure(HF). Methods Serum CysC was detected by ELISA and plasma NHE1 mRNA was detected by real-time PCR.97 cases were diagnosed as the HF patients(the case group I),while 40 patients were diagnosed without HF but with coronary heart disease and hypertension(case group II),and 45 healthy subjects were also selected(control group).The CysC and NHE1 mRNA concentration were measured in all three groups.The differences in the levels of CysC and NHE1 mRNA in the blood of the three groups were analyzed,and the clinical value of the combined detection of two indicators in the diagnosis of heart failure was also analyzed. Results The levels of serum CysC and plasma NHE1 mRNA in group I were 1.67±0.27 mg/L and 1.38±0.21,respectively,and the levels of CysC and NHE1 mRNA in group II were 1.25±0.28 mg/L,and 1.09±0.19,respectively.The levels of CysC and NHE1 mRNA in the control group were 0.89±0.10 mg/L and0.89±0.25,respectively.There were significant differences between the two groups( P <0.05).The sensitivity and specificity of the parallel combining test for the diagnosis of heart failure were 94.85% and 87.06%,respectively,which was better than the sensitivity(88.66%)and specificity( 91.76%)of the CysC index alone or the sensitivity(63.92%)and specificity(95.29%)of NHE1 mRNA alone. Conclusion Combined detection of CysC and NHE1 mRNA has certain clinical value in early screening and diagnosis of heart failure.

关 键 词：血清CysC水平 NHE1mRNA 心力衰竭 诊断 

分 类 号：R541.6[医药卫生—心血管疾病] R446.1[医药卫生—内科学]