CHF合并贫血患者sST2、SF及铁调素水平的变化及意义  

Changes and roles of sST2,SF and hepcidin levels in patients with CHF and anemia

作　　者：张洪霞[1] 韩红[1] ZHANG Hongxia;HAN Hong(Department of Cardiology,Shenyang Seventh People's Hospital,Shenyang 110003,Liaoning,Chin)

机构地区：[1]沈阳市第七人民医院心内科,辽宁沈阳110003

出　　处：《检验医学》2020年第9期912-916,共5页Laboratory Medicine

摘　　要：目的探讨慢性心力衰竭(CHF)合并贫血患者可溶性致癌抑制因子2(sST2)、血清铁蛋白(SF)及铁调素水平的变化及意义。方法选取CHF患者182例,根据是否合并贫血分为CHF合并贫血组(89例)、CHF未合并贫血组(93例)。以43名体检健康者作为正常对照组。收集所有对象的临床资料及实验室检测结果[空腹血糖(FBG)、C反应蛋白(CRP)、氨基末端B型钠尿肽原(NT-proBNP)、血红蛋白(Hb)、血细胞比容(HCT)、血清铁],同时检测sST2、SF和铁调素水平。采用Pearson相关分析评估各项指标之间的相关性。采用Logistic回归分析评估CHF合并贫血的危险因素。采用受试者工作特征(ROC)曲线评估各项指标诊断CHF合并贫血的价值。结果CHF合并贫血组和CHF未合并贫血组CRP、NT-proBNP及sST2水平均高于正常对照组(P<0.05)。CHF合并贫血组CRP、NT-proBNP、sST2、铁调素水平均高于CHF未合并贫血组(P<0.05),Hb、血清铁及SF水平均低于CHF未合并贫血组(P<0.05)。Logistic回归分析结果显示,CRP、NT-proBNP、sST2、铁调素水平升高是CHF合并贫血发生的危险因素(P<0.05);Hb、HCT、血清铁及SF水平升高是CHF合并贫血发生的保护因素(P<0.05)。Pearson相关分析结果显示,Hb、SF与sST2呈负相关(r值分别为-0.1678、-0.2914,P<0.05),铁调素与sST2呈正相关(r=0.3533,P<0.05)。ROC曲线分析结果显示,Hb、HCT、sST2、SF、铁调素以及sST2、SF和铁调素的联合检测模型诊断CHF合并贫血的曲线下面积(AUC)分别为0.640、0.531、0.734、0.789、0.845、0.912。结论sST2、铁调素及SF与CHF合并贫血密切相关,或可作为CHF合并贫血的辅助诊断指标。Objective To investigate the changes and roles of soluble suppression of tumorigenicity 2(sST2),serum ferritin(SF)and hepcidin in patients with chronic heart failure(CHF)and anemia.Methods A total of 182 CHF patients were enrolled.According to the presence or absence of anemia,they were classified into CHF-anemia group(89 cases)and CHF-non-anemia group(93 cases).Totally,43 healthy subjects were enrolled as healthy control group.The clinical data and laboratory determination results[fasting blood glucose(FBG),C-reactive protein(CRP),N-terminal pro-B-type natriuretic peptide(NT-proBNP),hemoglobin(Hb),hematocrit(HCT)and serum iron]were collected.The levels of sST2,SF and hepcidin were determined.The correlations were evaluated by Pearson correlation analysis.The risk factors of CHF combined with anemia were evaluated by Logistic regression analysis.The diagnostic role of each index for CHF combined with anemia was evaluated by receiver operating characteristic(ROC)curve.Results The levels of CRP,NT-proBNP and sST2 in CHF-anemia group and CHF-non-anemia group were higher than those in healthy control group(P<0.05).The levels of CRP,NT-proBNP,sST2 and hepcidin in CHF-anemia group were higher than those in CHF-non-anemia group(P<0.05),while the levels of Hb,serum iron and SF were lower(P<0.05).Logistic regression analysis showed that the increased levels of CRP,NT-proBNP,sST2 and hepcidin were risk factors for CHF combined with anemia(P<0.05),while the increased levels of Hb,HCT,serum iron and SF were protective factors(P<0.05).Pearson correlation analysis showed that Hb and SF were negatively correlated with sST2(r=-0.1678 and-0.2914,P<0.05),while hepcidin was positively correlated with sST2(r=0.3533,P<0.05).The results of ROC curve analysis showed that the areas under curves(AUC)of Hb,HCT,sST2,SF and hepcidin for the diagnosis of CHF combined with anemia were 0.640,0.531,0.734,0.789 and 0.845,respectively.The AUC of sST2 combined with SF and hepcidin for the diagnosis of CHF combined with anemia was 0.912.Conclusions

关 键 词：可溶性致癌抑制因子2 铁蛋白 铁调素 慢性心力衰竭 贫血 

分 类 号：R446.1[医药卫生—诊断学]