慢性心力衰竭患者血清Mb,cTnI,IL-8和hs-CRP水平表达与心功能分级的相关性研究  

Correlation between the Expression of Serum MB,cTnI,IL-8,hs-CRP and Cardiac Function in Patients with Chronic Heart Failure

作　　者：易福凌 陈伟芝 王禺[1] YI Fu-ling;CHEN Wei-zhi;WANG Yu(Department of Clinical Laboratory,the First Hospital of Xi’an City,Xi’an 710004,China;Department of Clinical Laboratory,Red Cross Society Hospital Affiliated to Xi’an Jiaotong University,Xi’an 710054,China)

机构地区：[1]西安市第一医院检验科,西安710004 [2]西安交通大学附属红会医院检验科,西安710054

出　　处：《现代检验医学杂志》2021年第3期58-61,67,共5页Journal of Modern Laboratory Medicine

基　　金：陕西省2020年重点研发计划(2020SF-255)。

摘　　要：目的探讨慢性心力衰竭(CHF)患者血清肌红蛋白(Mb)、心肌肌钙蛋白I(cTnI)、白细胞介素-8(IL-8)及超敏C反应蛋白(hs-CRP)水平与心功能分级的相关性。方法选择2019年1~12月期间于西安交通大学附属红会医院和西安市第一医院就诊的150例CHF患者作为观察组,另选择同期健康体检的50例正常人群作为对照组。采用荧光酶免法检测各组研究对象的Mb和cTnI水平。采用酶联免疫吸附法和散射免疫比浊法测定IL-8和hs-CRP水平。建立受试者工作特征(ROC)曲线评价Mb,cTnI,IL-8及hs-CRP在诊断CHF中的临床意义。比较分析血清Mb,cTnI,IL-8及hs-CRP水平与心功能分级的相关性。结果观察组和对照组的血清水平分别为Mb(102.16±31.55μg/L vs 31.35±12.28μg/L),cTnI(3.88±1.13ng/ml vs 0.76±0.21ng/ml),IL-8(34.71±8.46ng/ml vs 8.32±2.25ng/ml),hs-CRP(5.62±1.73mg/L vs 0.86±0.31mg/L)。观察组的血清Mb,cTnI,IL-8及hs-CRP水平均显著高于对照组(t=15.160~21.770,均P<0.01)。Ⅰ级~Ⅳ级心功能分级患者的血清水平分别为Mb(49.17±11.35,57.45±13.74,96.22±26.16和155.74±39.37μg/L),cTnI(1.39±0.47,2.73±0.68,4.01±1.32和5.15±1.67ng/ml),IL-8(13.26±3.77,19.38±5.23,35.25±9.11和54.33±11.36ng/ml),hs-CRP(1.81±0.45,2.21±0.57,5.72±1.64和6.81±1.89mg/l)。不同心功能分级患者血清Mb,cTnI,IL-8及hs-CRP水平由高到低依次为:Ⅳ级>Ⅲ级>Ⅱ级>Ⅰ级,差异均有统计学意义(F=66.350~134.600,均P<0.01)。ROC曲线分析显示血清Mb,cTnI,IL-8及hs-CRP检测CHF的曲线下面积(AUC)分别为Mb[0.78(95%CI0.623~0.851)],cTnI[0.80(95%CI0.657~0.876)],IL-8[0.69(95%CI0.603~0.816)],hs-CRP[0.74(95%CI0.609~0.810)],均P<0.01。Mb,cTnI,IL-8及hs-CRP诊断CHF的阳性预测值、阴性预测值、敏感度及特异度分别为Mb(75.34,63.34,80.14和77.39),cTnI(74.15,61.27,75.64和74.88),IL-8(68.74,59.78,72.01和70.47),hs-CRP(69.46,60.45,70.58和67.46)。结论CHF患者血清Mb,cTnI,IL-8及hs-CRP水平均显著高于正常人群,Mb,cTnI,IL-8及hs-CRP水平与Objective To investigate the correlation between the levels of serum myoglobin(Mb),cardiac troponin I(cTnI),interleukin-8(IL-8)and high sensitivity protein C(hs-CRP)in patients with chronic heart failure(CHF).Methods 150 patients with CHF from January 2019 to December 2019 in the Red Cross Society Hospital Affiliated to Xi’an Jiaotong University and the First Hospital of Xi’an City were selected as the observation group,and 50 healthy people in the same period were selected as the control group.The levels of Mb and cTnI were detected by enzyme immunoassay.The levels of IL-8 and hs-CRP were measured by enzyme linked immunosorbent assay and nephelometry.Receiver operating characteristic(ROC)curve was established to evaluate the clinical significance of Mb,cTnI,IL-8 and hs-CRP in the diagnosis of CHF.The correlation between serum Mb,cTnI,IL-8,hs-CRP and cardiac function was analyzed.Results The levels of serum in observation group and control group were Mb(102.16±31.55μg/L vs 31.35±12.28μg/L),cTnI(3.88±1.13ng/ml vs 0.76±0.21ng/ml),IL-8(34.71±8.46ng/ml vs 8.32±2.25ng/ml),hs-CRP(5.62±1.73mg/L vs 0.86±0.31mg/L),respectively.The serum levels of Mb,cTnI,IL-8 and hs-CRP in the observation group were significantly higher than those in the control group(t=15.160~21.770,all P<0.01).The serum levels in patients with cardiac function classification of grade Ⅰ and grade Ⅳ were Mb(49.17±11.35,57.45±13.74,96.22±26.16 and 155.74±39.37)μg/L,cTnI(1.39±0.47,2.73±0.68,4.01±1.32 and 5.15±1.67)ng/ml,IL-8(13.26±3.77,19.38±5.23,35.25±9.11 and 54.33±11.36)ng/ml,hs-CRP(1.81±0.45,2.21±0.57,5.72±1.64 and 6.81±1.89mg/l).The levels of serum Mb,cTnI,IL-8 and hs-CRP in patients with different cardiac function grades were in the order of grade Ⅳ>grade Ⅲ>grade Ⅱ>grade Ⅰ(F=66.350~134.600,all P<0.01).ROC curve analysis showed that the area under curve(AUC)of serum Mb,cTnI,IL-8 and hs-CRP in detecting CHF was Mb[0.78(95%CI:0.623~0.851)],cTnI[0.80(95%CI:0.657~0.876)],IL-8[0.69(95%CI:0.603~0.816)],hs-CRP[0.74(9

关 键 词：慢性心力衰竭 心功能分级 肌钙蛋白I 肌红蛋白 细胞白介素-8 超敏C反应蛋白 

分 类 号：R541.6[医药卫生—心血管疾病] R446.112[医药卫生—内科学]