血清FGF-23、KIM-1和NT-proBNP对心肾综合征患者预后的评估价值  

Clinical value of serum FGF-23,KIM-1 and NT-proBNP in predicting prognosis of patients with cardiorenal syndrome

作　　者：裴培 顾卓荣 张小婷 PEI Pei;GU Zhuorong;ZHANG Xiaoting(Department of Obstetrics and Gynecology,Shanghai Tongren Hospital,Shanghai 200050,China)

机构地区：[1]上海市同仁医院妇产科,200050

出　　处：《河北医药》2021年第10期1493-1496,共4页Hebei Medical Journal

摘　　要：目的观察血清成纤维细胞生长因子23(FGF-23)、肾损伤分子-1(KIM-1)和N末端B型氨基端利钠肽原(NT-proBNP)在心肾综合征患者预测预后的临床价值。方法选择2016年1月至2018年6月诊治的心肾综合征患者108例,为心肾综合征组。选择同期诊治的单纯心力衰竭患者和健康体检者,分别为单纯心力衰竭组(45例)和健康对照组(30例)。采用酶联免疫吸附法检测3组血清FGF-23、KIM-1和NT-proBNP水平。观察3组血清FGF-23、KIM-1和NT-proBNP水平变化,心肾综合征患者血清FGF-23、KIM-1和NT-proBNP水平与心功能、肾功能和死亡的关系,及其在预测1年内出现死亡的灵敏度和特异性。结果心肾综合征患者血清FGF-23、KIM-1和NT-proBNP水平明显高于单纯心力衰竭组和健康对照组(P<0.01),而单纯心力衰竭组明显高于健康对照组(P<0.01)。心肾综合征患者血清FGF-23、KIM-1和NT-proBNP水平随着心功能分级和肾功能分期升高而升高(P<0.01)。心肾综合征患者死亡组血清FGF-23、KIM-1和NT-proBNP水平明显高于生存组(P<0.01)。心肾综合征患者血清FGF-23、KIM-1和NT-proBNP水平在预测预后方面具有较高的灵敏度和特异性,联合3个指标在预测预后具有更高的诊断效能,其灵敏度为85.2%,特异性为92.6%,其曲线下面积(ACU)明显高于FGF-23(Z=2.084,P<0.05)、KIM-1(Z=2.653,P<0.01)和NT-proBNP(Z=2.211,P<0.01)。结论血清FGF-23、KIM-1和NT-proBNP水平是评价心肾综合征严重程度的指标,在预测预后具有重要临床价值。Objective To investigate the clinical value of serum fibroblast growth factor 23(FGF23),kidney injury molecule 1(KIM-1),and N terminal B type amino terminal natriuretic peptide(NT-proBNP)in predicting prognosis of patients with cardiorenal syndrome.Methods A total of 108 patients with cardiorenal syndrome who were diagnosed and treated in our hospital from January 2016 to June 2018 were enrolled as cardiorenal syndrome group,at the same time,the 45 patients with simple heart failure were enrolled as heart failure group,and 30 healthy subjects who underwent physical examination were enrolled as control group.The serum levels of FGF-23,KIM-1 and NT-proBNP were detected by enzyme linked immunosorbent assay.The serum levels of FGF-23,KIM-1 and NT-proBNP,the correlation between the serum levels of FGF-23,KIM-1,NT-proBNP,cardiac function,renal function and the death of patients o were bserved and compared among the three groups.Results The serum levels of FGF-23,KIM-1 and NT-proBNP in cardiorenal syndrome group were significantly higher than those in heart failure group and control group(P<0.01),moreover,which in heart failure group were significantly higher than those in control group(P<0.01).The serum levels of FGF-23,KIM-1 and NT-proBNP in cardiorenal syndrome group were increased with the increase of cardiac function grade and renal function stage(P<0.01),moreover,which in death case group were significantly higher than those in survival case group(P<0.01).In addition the serum levels of FGF-23,KIM-1,and NT-proBNP had higher sensitivity and specificity in predicting prognosis of patients with cardiorenal syndrome.The sensitivity and specificity of combined detection of the three indexes were 85.2%and 92.6%,respectively,and its area under the curve(AUC)was significantly higher than of FGF-23,KIM-1 and NT-proBNP(P<0.01).Conclusion The serum levels FGF-23,KIM-1 and NT-proBNP are the indexes in evaluating the severity degree of patients with cardiorenal syndrome,which have important clinical value in predicting prognos

关 键 词：成纤维细胞生长因子23 肾损伤分子-1 N末端B型氨基端利钠肽原 心肾综合征 

分 类 号：R541.6[医药卫生—心血管疾病]