慢性心力衰竭患者血清肝细胞生长因子、可溶性ST2及D-二聚体水平与心功能及心血管事件的关系  

The relationship between the levels of hepatocyte growth factor,solubility suppression of tumorigenicity 2,D-dimer and cardiac function and cardiovascular events in patients with chronic heart failure

作　　者：姜炜[1] 尹析凡[1] 朱洁琳 Jiang Wei;Yin Xifan;Zhu Jielin(Huzhou Third People's Hospital of Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市第三人民医院,313000

出　　处：《心脑血管病防治》2021年第5期426-429,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的分析慢性心力衰竭患者血清肝细胞生长因子(HGF)、可溶性ST2(sST2)及D-二聚体(D-dimer)水平与心功能及心血管事件的关系。方法选取2017年6月到2019年6月湖州市第三人民医院慢性心力衰竭患者140例,依据美国纽约心脏病协会(NYHA)分级标准将其分为NYHAⅡ级组40例、Ⅲ级组54例、Ⅳ级组46例,另选取同期来我院进行体检的健康人群60例作为对照组。比较各组HGF、sST2、D-dimer水平及超声心动图参数,分析相关性;比较慢性心力衰竭发生不良心血管事件患者与未发生不良心血管事件患者HGF、sST2及D-dimer水平,绘制ROC曲线以评价HGF、sST2、D-dimer水平对慢性心力衰竭患者心血管事件的检测价值。结果与健康体检者比较,慢性心力衰竭患者血清HGF、sST2、D-dimer水平及左心室舒张末期内径(LVEDD)水平升高(t=12.389、16.562、20.898、11.808,P<0.05),左心室射血分数(LVEF)水平降低(t=-13.425,P<0.05);Ⅳ级组HGF、sST2、D-dimer水平及LVEDD水平明显高于Ⅲ级组(P<0.05),LVEF水平明显低于Ⅲ级组(P<0.05);Ⅲ级组HGF、sST2、D-dimer水平及LVEDD水平明显高于Ⅱ级组(P<0.05),LVEF水平明显低于Ⅱ级组(P<0.05);慢性心力衰竭患者血清HGF、sST2、D-dimer水平与LVEDD呈正相关(r=0.574、0.235、0.479,P<0.05),与LVEF呈负相关(r=-0.540、-0.333、-0.505,P<0.05);慢性心力衰竭患者不良心血管事件发生率为45.00%,发生不良心血管事件患者HGF、sST2、D-dimer水平明显高于未发生不良心血管事件患者(t=7.300、6.703、8.852,P<0.05);HGF、sST2、D-dimer三项联合检测对患者心血管不良事件是否发生具有较高的预测价值(AUC=0.900)。结论慢性心力衰竭患者血清HGF、sST2、D-dimer水平明显升高,其水平高低与患者心功能受损严重程度密切相关,且对患者心血管不良事件是否发生具有较高的预测价值。Objective To analyze the relationship between serum levels of hepatocyte growth factor(HGF),solubility suppression of tumorigenicity 2(sST2),D-dimer and cardiac function and cardiovascular events in patients with chronic heart failure.Methods A total of 140 patients with chronic heart failure in Huzhou Third People’s Hospital from June 2017 to June 2019 were selected and divided into grade Ⅱ group(n=40),grade Ⅲ group(n=54) and grade Ⅳ group(n=46) according to the New York Heart Association(NYHA) classification,another 60 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.The levels of HGF,sST2,D-dimer and echocardiography parameters were compared in each group,and the correlation was analyzed;the levels of HGF,sST2 and D-dimer in patients with and without adverse cardiovascular events were compared,and ROC curve was used to evaluate the predictive value of HGF,sST2 and D-dimer levels on cardiovascular events in patients with chronic heart failure.Results Compared with healthy people,the levels of serum HGF,s ST2,D-dimer and left ventricular end-diastolic dimension(LVEDD) in chronic heart failure patients were increased(t=12.389,16.562,20.898,11.808;P <0.05),the level of left ventricular ejection fraction(LVEF) was decreased(t=-13.425,P <0.05).In grade Ⅳ group,the levels of serum HGF,sST2,D-dimer and LVEDD were higher than those in grade Ⅲ group(P <0.05),the level of LVEF was lower than that in grade Ⅲ group(P <0.05);In grade Ⅲ group,the levels of serum HGF,sST2,D-dimer and LVEDD were higher than those in grade II Group(P <0.05),the level of LVEF was lower than that in grade Ⅱ Group(P <0.05).Serum HGF,sST2,D-dimer levels were positively correlated with LVEDD(r=0.574,0.235,0.479;P <0.05),and negatively correlated with LVEF(r=-0.540,-0.333,-0.505;P <0.05).The incidence of adverse cardiovascular events in patients with chronic heart failure was 45.00%.The levels of HGF,sST2 and D-dimer in patients with adverse cardiovascular ev

关 键 词：慢性心力衰竭 肝细胞生长因子 D-二聚体 心功能 心血管事件 

分 类 号：R541.6[医药卫生—心血管疾病]