射血分数保留的心力衰竭患者病情严重程度与血清TSP-2、sAXL和GDF-15的关系研究  

Study on the correlation between serum TSP-2,sAXL,GDF-15 levels and severity of disease in patients with heart failure of preserved ejection fraction

作　　者：黄慧君[1] 沈艳[1] 李瑾[1] 王伶俐[1] 李为为 蒋云[1] 宋艳秋[1] 王占成[1] HUANG Huijun;SHEN Yan;LI Jin(Department of Cardiology,Shanghai Eighth People’s Hospital,Shanghai 200235,China)

机构地区：[1]上海市第八人民医院心内科,200235

出　　处：《河北医药》2021年第16期2451-2454,共4页Hebei Medical Journal

基　　金：上海市卫生和计划生育委员会科研课题青年项目(编号:2017ZY0402)。

摘　　要：目的探讨射血分数保留的心力衰竭(HFpEF)患者血清血小板吸附蛋白2(TSP-2)、可溶性AXL(sAXL)、生长分化因子15(GDF-15)水平与病情严重程度的关系,并探讨三者对HFpEF的诊断价值。方法选择2017年3月至2019年8月收治的152例HFpEF患者(HFpEF组)和100例门诊体检的健康志愿者(对照组)。采用酶联免疫吸附试验检测血清TSP-2、sAXL、GDF-15水平,分析TSP-2、sAXL、GDF-15与HFpEF患者美国纽约心脏病协会(NYHA)心功能分级、血清N末端B型利钠肽原(NT-proBNP)水平、左心室射血分数(LVEF)、左心房内径(LAD)、舒张末期左心室内径(LVEDD)的相关性。受试者工作特征曲线(ROC)分析TSP-2、sAXL、GDF-15诊断HFpEF的价值。结果HFpEF组血清TSP-2、sAXL、GDF-15、NT-proBNP水平、LAD、LVEDD高于对照组(P<0.05),LVEF低于对照组(P<0.05)。血清TSP-2、sAXL、GDF-15水平随着HFpEF患者NYHA心功能分级的增加而升高(P<0.05)。相关性分析结果显示血清TSP-2、sAXL、GDF-15与HFpEF患者NYHA心功能分级、血清NT-proBNP水平均呈正相关(rs=0.462、0.406、0.564;r=0.512、0.535、0.515;P<0.05)。ROC分析结果显示TSP-2、sAXL、GDF-15、TSP-2+sAXL+GDF-15诊断HFpEF的曲线下面积(AUC)分别为0.715(95%CI:0.649~0.782)、0.713(95%CI:0.648~0.778)、0.750(95%CI:0.690~0.811)、0.926(95%CI:0.891~0.960),灵敏度分别为71.05%、73.68%、67.11%、92.76%,特异度分别为71.00%、69.00%、75.00%、89.00%。结论HFpEF患者TSP-2、sAXL、GDF-15水平明显升高,TSP-2、sAXL、GDF-15水平与HFpEF患者病情严重程度密切相关,可能作为HFpEF诊断和病情评估的辅助指标。Objective To investigate the correlation between the serum levels of platelet adsorbed protein 2(TSP 2),soluble AXL(sAXL),growth differentiation factor 15(GDF-15)and the severity of the disease in heart failure patients with preserved ejection fraction(HFpEF),and to explore the diagnostic value of the three indexes for HFpEF.Methods A total of 152 patients HFpEF patients(HFpEF group)who were treated in our hospital from March 2017 to August 2019 and 100 healthy subjects(control group)were enrolled in the study.Enzyme-linked immunosorbent assay was used to detect the serum levels of TSP-2,sAXL,GDF-15,and the correlation of TSP-2,sAXL,and GDF-15 with New York Heart Association(NYHA)heart function classification of patients,serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)level,left ventricular ejection fraction(LVEF),left atrial diameter(LAD),and left ventricular end-diastolic diameter(LVEDD)was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the value of TSP-2,sAXL,and GDF-15 in diagnosis of HFpEF.Results The serum levels of TSP-2,sAXL,GDF-15,NT-proBNP,LAD and LVEDD in HFpEF group were significantly higher than those in the control group(P<0.05),while LVEF levels were significantly lower than those in control group(P<0.05).And the serum levels of TSP-2,sAXL and GDF-15 were significantly increased with the increase of NYHA cardiac function classification in patients with HFpEF(P<0.05).The correlation analysis showed that the serum levels of TSP-2,sAXL,and GDF-15 were positively correlated with NYHA cardiac function classification and serum NT-proBNP level in HFpEF patients(P<0.05).ROC analysis results showed that the area under the ROC curve(AUC)of TSP-2,sAXL,GDF-15,and TSP-2+sAXL+GDF-15 in diagnosis of HFpEF was 0.715(95%CI:0.649~0.782),0.713(95%CI:0.648~0.778),0.750(95%CI:0.690~0.811),and 0.926(95%CI:0.891~0.960),respectively,and the sensitivity was 71.05%,73.68%,67.11%,and 92.76%,respectively,and the specificity was 71.00%,69.00%,75.00%,and 89.00%,respectively.Conclusion The lev

关 键 词：射血分数 心力衰竭 血小板吸附蛋白2 可溶性AXL 生长分化因子15 N末端B型利钠肽原 诊断 

分 类 号：R541.6[医药卫生—心血管疾病]