sST2、IL-33与慢性肾衰竭患者心力衰竭的相关性研究  

The correlation between sST2, IL-33 and heart failure in patients with chronic renal failure

作　　者：汤丰宁 龙勇[1,2] 丁宁[1,2] 李华[1,2] 李长罗[1,2] TANG Feng-ning;LONG Yong;DING Ning;LI Hua;LI Chang-luo(CCU,Changsha Central Hospital,Changsha 410004,China;EICU,Changsha Central Hospital,Changsha 410004,China)

机构地区：[1]长沙市中心医院CCU,长沙410004 [2]长沙市中心医院EICU,长沙410004

出　　处：《中国医学前沿杂志（电子版）》2019年第4期44-48,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：湖南省卫计委科研课题(B2017150)

摘　　要：目的探讨可溶性ST2(soluble ST2,sST2)、白介素-33(interleukin-33,IL-33)与慢性肾衰竭患者心力衰竭的相关性。方法选取2017年10月1日至2018年8月31日本院收治的慢性肾脏病(chronic kidney disease,CKD)患者116例为研究对象,根据国际改善全球肾脏病预后组织指南将其分为CKD 1～5期,同时选取2018年1月1日至2018年8月31日于本院健康体检的健康成人28例纳入对照组。比较不同CKD分期患者和对照组研究对象s ST2、IL-33、N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)的水平。对其中70例CKD 5期患者进行心功能分级,观察不同心功能分级患者sST2、IL-33、NT-proBNP表达水平的差异,并使用ROC曲线分析s ST2、IL-33、NT-proBNP诊断CKD 5期患者心功能Ⅳ级的价值。结果 CKD 1～5期患者sST2、IL-33、NT-proBNP水平均显著高于对照组(P_均<0.05)。CKD 5期患者NT-proBNP水平均显著高于CKD 1～4期患者(P_均<0.05)。随着心功能分级的增加,sST2、IL-33及NT-proBNP水平均逐渐升高,且不同心功能分级CKD 5期患者sST2、IL-33水平比较差异均具有显著性(P_均<0.05)。s ST2、IL-33及NT-proBNP对CKD 5期患者心功能Ⅳ级均具有一定的诊断价值,但sST2和IL-33的诊断价值均显著高于NT-proBNP。结论 sST2、IL-33及NT-proBNP在慢性肾衰竭患者中的表达水平均受心功能影响,但NT-proBNP受肾功能影响较大,而sST2、IL-33受肾功能影响较小,因此使用sST2、IL-33评价慢性肾衰竭患者的心功能可能更有价值。Objective To investigate the correlation between soluble ST2(sST2),interleukin-33(IL-33)and heart failure in patients with chronic renal failure.Method From October 1,2017 to August 31,2018,116 patients with chronic kidney disease(CKD)treated in our hospital were selected as subjects,they were divided into CKD stage 1 ~ 5 according to kidney disease:improving global outcomes(KDIGO),at the same time,28 healthy adults who underwent physical examination in our hospital were selected and included in control group from January 1,2018 to August 31,2018.The levels of sST2,IL-33 and N-terminal pro-B-type natriuretic peptide(NT-proBNP)in patients with different CKD stage and control group were compared.Cardiac function classification was performed in 70 patients with CKD stage 5,and the levels of sST2,IL-33 and NT-proBNP in patients with different cardiac function grades were observed.ROC curve was used to analyze the value of sST2,IL-33 and NT-proBNP in the diagnosis of grade Ⅳ cardiac function in patients with CKD stage 5.Result The levels of sST2,IL-33 and NT-proBNP in patients with CKD stage 1 ~ 5 were significantly higher than those in control group(Pall<0.05).The levels of NT-proBNP in patients with CKD stage 5 were significantly higher than those in patients with CKD stage 1 ~ 4(Pall<0.05).With the increase of cardiac function classification,the levels of sST2,IL-33 and NT-proBNP increased gradually,and there were significant differences in the levels of sST2 and IL-33 among CKD 5 patients with different cardiac function grades(Pall<0.05).sST2,IL-33 and NT-proBNP had certain diagnostic value for grade Ⅳ cardiac function in patients with CKD stage 5,but the diagnostic value of sST2 and IL-33 were significantly higher than NT-proBNP.Conclusion The expression of sST2,IL-33 and NT-proBNP in patients with chronic renal failure is affected by cardiac function,but NT-proBNP is greatly affected by renal function,while sST2 and IL-33 are less affected by renal function.Therefore,sST2 and IL-33 may be more valuable in ev

关 键 词：慢性肾衰竭 心功能不全 可溶性ST2 白介素-33 N末端B型利钠肽原 

分 类 号：R692.5[医药卫生—泌尿科学]