hs-cTnT、s ST2联合BNP评估射血分数降低的慢性心力衰竭的临床意义  

Clinical value and correlation of hs-cTnT,sST2 combined with BNP in chronic heart failure with reduced ejection fraction

作　　者：杨萍[1] 刘培晶[1] 丁澍[1] 王中群[1] 邵晨[1] 严金川[1] YANG Ping;LIU Pei-jing;DING Shu;WANG Zhong-qun;SHAO Chen;YAN Jin-chuan(Department of Cardiology,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001,China)

机构地区：[1]江苏大学附属医院心内科

出　　处：《江苏大学学报（医学版）》2019年第5期414-418,共5页Journal of Jiangsu University：Medicine Edition

基　　金：江苏省社会发展基金资助项目(BE2017699);江苏省研究生科研创新计划(KYCX17_1818);镇江市社会发展项目(SH2017030);镇江市2018年度科技创新资金资助项目(SS2018008)

摘　　要：目的:探讨高敏肌钙蛋白T(high sensitivity troponin T,hs-cTnT),血清可溶性人基质裂解素2(soluble suppression of tumorigenicity 2,sST2)及B型利钠肽(BNP)对伴有射血分数降低的慢性心力衰竭(heart failure with reduced ejection fraction,HFrEF)危险分层及预后评估的价值。方法:收集左室射血分数(left ventricular ejection fraction,LVEF)≤40%的慢性心衰患者59例为研究组,纳入同期体检的无心力衰竭及心脏病史人群30例作为对照组。比较两组研究对象血清hs-cTnT、sST2含量,以及两者与BNP的相关性;分析研究组患者hs-cTnT、sST2、BNP含量与心功能分级、再住院率、心血管死亡发生率的相关性。结果:研究组患者血清hs-cTnT和sST2含量明显高于对照组(P均<0.001);且均与BNP呈正相关(r=0.783、P<0.01,r=0.794、P<0.01)。hs-cTnT含量与LVEF呈负相关(Ⅱ级:r=-0.605、P<0.05,Ⅲ-Ⅳ级:r=-0.707、P<0.05);sST2含量与LVEF呈负相关(Ⅱ级:r=-0.607、P<0.05,Ⅲ-Ⅳ级:r=-0.762、P<0.05);BNP与LVEF正相关(Ⅱ级:r=0.505、P<0.05,Ⅲ-Ⅳ级:r=0.497、P<0.05)。院外随访6个月,hs-cTnT、sST2高值组非计划心衰再住院、心血管死亡的发生率明显高于低值组(P<0.05)。结论:hs-cTnT、sST2联合BNP对HFrEF患者病情的严重程度及心血管事件具有良好的预测价值。Objective:To explore the clinical significance and correlationship of high sensitivity-tro-ponin T(hs-cTnT),soluble suppression of tumorigenicity 2(sST2)and B-type natriuretic peptide(BNP)in chronic heart failure with reduced ejection fraction(HFrEF).Methods:Fifty-nine patients with chronic heart failure whose left ventricular ejection fraction(LVEF)was less than 40%were enrolled in the study group.Thirty patients with no history of heart failure and heart disease were collected as control group during the same period.The serum levels of hs-cTnT,sST2 and their correlation with BNP were compared between the two groups,and the levels of hs-cTnT,sST2 and BNP were detected to correlate with cardiac function classification,re-hospitalization rate and cardiovascular mortality rate.Results:The levels of hs-cTnT and sST2 were significantly higher than those in the control group(P<0.001),and both were positively correlated with BNP(r=0.783 and 0.794,both P<0.01),respectively.The hs-cTnT were negatively correlated with LVEF(Ⅱ:r=-0.605,P<0.05;Ⅲ-Ⅳ:r=-0.707,P<0.05).The sST2 were negatively correlated with LVEF(Ⅱ:r=-0.607,P<0.05;Ⅲ-Ⅳ:r=-0.762,P<0.05),while BNP and LVEF were positively correlated(r=0.505,P<0.05;r=0.497,P<0.05).After six months of follow-up outside hospital,the incidence of re-hospitalization and cardiovascular death was significantly higher in the hs-cTnT and sST2 high-value groups than that in the low-value group(P<0.05).Conclusion:hs-cTnT,sST2 combined with BNP have a good predictive value for the severity of HFrEF patients and cardiovascular events.

关 键 词：高敏肌钙蛋白T 可溶性人基质裂解素2 B型利钠肽 慢性心力衰竭 危险分层 心血管事件 

分 类 号：R541.6[医药卫生—心血管疾病]