血清黄嘌呤氧化酶与MCP-1在慢性心力衰竭患者中的表达意义及对短期预后的预测价值  

Expression significance of serum xanthine oxidase and monocyte chemotactic protein 1 and their predictive value to short-term prognosis in patients with chronic heart failure

作　　者：董志华 周长宇 张刚 唐敏 王高频 于晓玲 Dong Zhihua;Zhou Changyu;Zhang Gang;Tang Min;Wang Gaopin;Yu Xiaoling(Third Departments of Cardiology,Central Hospital of Liaoyang City,Liaoning Province,Liaoyang 111000,China;不详)

机构地区：[1]辽阳市中心医院心内三科,辽阳111000 [2]锦州医科大学附属第一医院心内科,锦州121004

出　　处：《中国循证心血管医学杂志》2020年第11期1352-1356,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：辽宁省自然科学基金指导计划(201602827)

摘　　要：目的探讨血清黄嘌呤氧化酶(XO)及单核细胞趋化蛋白-1(MCP-1)在慢性心力衰竭(CHF)患者中的表达意义及对短期预后的预测价值。方法前瞻性选择2016年1月至2018年12月于辽阳市中心医院心内科确诊并接受治疗的CHF患者104例作为CHF组,另选择104例健康志愿者作为健康对照组,检测血清XO和MCP-1水平,以及与CHF患者血浆N末端脑钠肽前体(NT-proBNP)含量和心功能的相关性。采用受试者工作特征(ROC)曲线分析血清XO和MCP-1水平对CHF患者1年内主要心血管不良事件(MACE)的预测价值。结果CHF组血清XO、MCP-1基线水平明显高于健康对照组(P<0.05)。经多因素Logistic回归分析,校正各项混杂因素后,XO和MCP-1是CHF发生的独立危险因素(P<0.05)。与NYHAⅡ级CHF患者相比,NYHAⅢ~Ⅳ级CHF患者血清XO和MCP-1水平升高(P<0.05)。经Pearson相关性分析,CHF组血清XO和MCP-1水平与NT-proBNP呈正相关性,且与左室射血分数(LVEF)都具有显著的相关性(P<0.05)。随访1年,21例患者发生MACE,经ROC曲线分析,血清XO、MCP-1以及联合指标预测CHF患者短期预后不良的ROC曲线下面积分别为0.650(95%CI:0.516~0.784)、0.633(95%CI:0.507~0.759)、0.839(95%CI:0.745~0.933)。结论CHF患者血清XO和MCP-1水平较健康对照人群升高,且与心功能分级有关,对CHF患者短期内主要不良心血管事件的发生风险具有一定的预测价值。Objective To investigate the expression significance of serum xanthine oxidase(XO)and monocyte chemotactic protein 1(MCP-1)and their predictive value to short-term prognosis in patients with chronic heart failure(CHF).Methods CHF patients(n=104)were prospectively chosen into CHF group and healthy controls(n=104)were chosen into healthy control group from Departments of Cardiology in Central Hospital of Liaoyang City from Jan.2016 to Dec.2018.The levels of serum XO and MCP-1 were detected,and correlation between among them and content of plasma NT-proBNP and heart function was observed in CHF patients.The predictive value of serum XO and MCP-1 levels to incidence of major adverse cardiovascular events(MACE)within 1 y was analyzed by applying ROC curve in CHF patients.Results The baseline levels of serum XO and MCP-1 were significantly higher in CHF group than those in healthy control group(P<0.05).The results of Logistic regression analysis showed that the levels of serum XO and MCP-1 were independent factors of CHF after correcting different confounding factors(P<0.05).The levels of serum XO and MCP-1 increased in patients with NYHA grade II than those in patients with NYHA grades III-IV(P<0.05).The results of Pearson correlation analysis showed that the levels of serum XO and MCP-1 were positively correlated to NT-proBNP,and correlated significantly to LVEF(P<0.05).There were 21 patients had MACE after followed up for 1 y.The results of ROC curve analysis showed that the area under ROC curve of serum XO level was 0.650(95%CI:0.516~0.784),that of serum MCP-1 was 0.633(95%CI:0.507~0.759)and that of XO combined with MCP-1 was 0.839(95%CI:0.745~0.933)in predicting poor shot-term prognosis in CHF patients.Conclusion The levels of serum XO and MCP-1 are higher in CHF patients than those in healthy control population,which are correlated to heart function.The levels of serum XO and MCP-1 have some predictive value to risk of MACE incidence in CHF patients.

关 键 词：黄嘌呤氧化酶 单核细胞趋化蛋白-1 慢性心力衰竭 NYHA心功能分级 主要不良心血管事件 

分 类 号：R541.61[医药卫生—心血管疾病]