左心室射血分数保留性心力衰竭患者预后相关生物靶向标志物的表达特征  

Biomarkers and their predictive value in patients with heart failure with preserved ejection fraction

作　　者：汪润 曹高镇 吴旻 赵春婷 姚启恒 WANG Run;CAO Gao-zhen;WU Min;ZHAO Chun-ting;YAO Qi-heng(Shenzhen Hospital of University of HongKong,Shenzhen,Guangdong 518053)

机构地区：[1]香港大学深圳医院心内科,广东深圳518053

出　　处：《岭南心血管病杂志》2020年第2期190-194,共5页South China Journal of Cardiovascular Diseases

基　　金：深圳市科创委(项目编号:590708446)。

摘　　要：目的分析射血分数下降的心力衰竭(heart failure with reduced ejection fraction,HFrEF)和射血分数保留(或正常)的心力衰竭(heart failure with preserved ejection fraction,HFpEF)患者生物靶向标志物表达差异情况。评估生物靶向标志物对HFpEF识别与预后判断价值。方法连续选择2015年1月至2016年5月香港大学深圳医院100例HFpEF(左心室射血分数≥50%)及310例HFrEF(左心室射血分数<50%)患者,收集患者基本临床治疗与相关生物靶向标志物,以12个月不良事件为研究终点。结果HFpEF患者中,氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)浓度[1911(877~4130)pg/mL vs.3001(1498~6120)pg/mL,P<0.05]、高敏肌钙蛋白T(high-sensitivity troponin T,hsTnT)浓度[21.1(15.9~41)pg/mL vs.31.2(18.1~52.7)pg/mL,P<0.05]、高敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP)浓度[3.6(1.7~6.9)mg/L vs.2.1(0.9~4.8)mg/L,P<0.05]明显低于HFrEF患者,而胱抑素C浓度高于HFrEF患者[1.7(1.3~2.2)mg/L vs.1.4(1.0~2.0)mg/L,P<0.05],差异有统计学意义。而且在HFpEF组中白细胞介素-6,hsTnT和尿素氮与终点事件有关,NT-proBNP对HFpEF患者远期预后无统计学意义。结论生物标志物在HFpEF与HFrEF患者中存在差异性表达情况。在HFpEF患者中,预后相关的预测因子可能进一步提高临床对于HFpEF诊断、风险评估与治疗。Objectives To evaluate whether biomarkers reflecting pathophysiological pathways are different betweenpatients with heart failure with preserved(HFpEF)and heart failure with reduced ejection fraction(HFrEF),and toevaluate the prognostic value of biomarker in patients with HFpEF.MethodsA total of 310 patients with HFrEF[leftventricular ejection fraction(LVEF)≤50%]and 100 patients with HFpEF(LVEF≥50%)from January 2015 to May2016 in Shenzhen Hospital of University of HongKong were included.Endpoints were 12-month overall and heart failurehospitalization-free survival.Related biomarkers and clinical information were collected.ResultsConcentrations of N-terminal pro-brain natriuretic peptide(NT-proBNP)[1911(877-4130)vs.3001(1498-6120),P<0.05],high-sensitivity troponin T(hsTnT)[21.1(15.9-41)vs.31.2(18.1-52.7),P<0.05],high sensitivity C-reactive protein(hsCRP)[3.6(1.7-6.9)vs.2.1(0.9-4.8),P<0.05]in patients with HFpEF were significantly lower than those inpatients with HFrEF,and concentration of cystatin-C[1.7(1.3-2.2)vs.1.4(1.0-2.0),P<0.05]was significantly higherthan that in patients with HFrEF.Interleukin-6,hsTnT and blood urea nitrogen(BUN)were related to the endpoints ofHFpEF in HFpEF group.NT-proBNP had no significance in predicting endpoints in patients with HFpEF.Conclusions There are different expression profile of biomarkers between patients with HFpEF and HFrEF.The biomarkers withprognostic value of patients with HFpEF might improve the diagnosis,risk assessment and clinical treatment effects.

关 键 词：心力衰竭 左心室射血分数 生物靶向标志物 预后 

分 类 号：R541.6[医药卫生—心血管疾病]