预测心内膜弹力纤维增生症疗效的生物标志物分析  

Biomarkers for predicting the efficacy of endocardial fibroelastosis

作　　者：杨一妃 吕震宇[1] 金梅[1] YANG Yifei;LV Zhenyu;JIN Mei(Department of Pediatric Cardiac Center,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所小儿心脏中心,100029

出　　处：《心肺血管病杂志》2021年第2期147-151,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然基金面上项目(82070413)。

摘　　要：目的:寻找预测激素联合丙种球蛋白对于心内膜弹力纤维增生症患儿疗效的生物标志物。方法:对2014至2018年,首都医科大学附属北京安贞医院,诊断为心内膜弹力纤维增生症的患儿58例资料进行回顾分析,每例患儿均给予基础对症治疗、激素免疫治疗及丙种球蛋白2g/kg冲击治疗。以患儿治疗后LVEF绝对值上升≥10%或治疗后LVEF≥55%作为治疗有效的标准,将患儿分为治疗有效组和无效组,选取基线水平的患儿有无前驱感染、WBC、hs-CRP、CK-MB、cTnI、病毒感染指标(弓形虫抗体、风疹病毒抗体、单纯疱疹病毒(HSV I、Ⅱ型)抗体、巨细胞病毒抗体,EB病毒抗体,细小病毒19抗体阳性≥1项)、BNP、二尖瓣反流程度,8项作为基线预测候选指标。结果:治疗有效组与无效组比较,cTnI的差异有统计学意义(P=0.044);cTnI与疗效呈正相关(r=0.468,P<0.05),进一步绘制ROC曲线,曲线下面积为0.792。结论:cTnI高的患儿治疗疗效更好,提示cTnI可以作为辅助临床预测激素联合丙种球蛋白治疗儿童心内膜弹力纤维增生症疗效的标志物。Objective:Search for biomarkers to predict the therapeutic effect of hormone combined with gamma globulin on children with endocardial fibroelastosis.Methods:The data of 58 children diagnosed with endocardial elastosis from Beijing Anzhen Hospital,Capital Medical University from 2014 to 2018 were analyzed retrospectively.Each child was given basic symptomatic treatment,hormone and gamma globulin 2 g/kg treatment.The patients were divided into two groups:the effective group and the ineffective group.The presence or absence of precursor infection,white blood cell count(WBC),high-sensitivity C-reactive protein(hsCRP),CK-MB,cTnI,virus infection index(Toxoplasma antibody,rubella virus antibody,herpes simplex virus(HSV I,Ⅱ)antibody,cytomegalovirus antibody,EB virus antibody,parvovirus 19 antibody positive≥1 item),B-type brain natriuretic peptide(BNP),mitral regurgitation degree,8 items were used as baseline prediction candidate indexes.Results:The difference of troponin between the effective group and the ineffective group was statistically significant.Draw ROC curve,the area under the curve is 0.792.Conclusions:The treatment effect of children with high troponin was better,suggesting that troponin can be used as a marker to assist clinical prediction of the efficacy of hormones combined with gamma globulin in the treatment of children with endocardial elastin hyperplasia.

关 键 词：心内膜弹力纤维增生症 肌钙蛋白 生物标志物 

分 类 号：R54[医药卫生—心血管疾病]