血清可溶性CD146水平对HFmrEF老年群体的诊断价值  

Clinical diagnostic value of serum soluble CD146 in elderly patients with HFmrEF

作　　者：王晨彤 邹晨晨 张洁[1] 秦晓磊 辛建华 卢林 WANG Chen-tong(Mudanjiang Medical University,Mudanjiang 157011,China)

机构地区：[1]牡丹江医学院 [2]牡丹江医学院附属红旗医院,黑龙江牡丹江157011

出　　处：《牡丹江医学院学报》2022年第4期62-66,共5页Journal of Mudanjiang Medical University

基　　金：牡丹江医学院研究生创新科研项目(YJSCX-MY41)。

摘　　要：目的检测老年射血分数中间值心力衰竭(HFmrEF)患者血清可溶性CD146(sCD146)的水平,探讨其对老年HFmrEF患者的临床诊断价值。方法选取2020年9月至2021年10月间牡丹江医学院附属红旗医院老年病科和心血管内科就诊射血分数(LVEF:40%~49%)、纽约心功能分级(NYHA分级)Ⅱ级~Ⅳ级的老年心衰患者34例(老年HFmrEF组),非老年心衰患者34例(非老年HFmrEF组),同期健康体检老年者31例(健康老年组)作为研究对象。收集所有患者的年龄、性别、血压、心率、总胆红素、血肌酐、胆固醇等数据,所有患者均常规行超声心动图检查,检测血清N末端前体脑利钠肽(NT-proBNP)、sCD146水平。比较各组患者的一般资料、NT-proBNP、超声心动图相关指标、sCD146水平的差异,分析相关性,受试者工作特征曲线(ROC)评价sCD146对HFmrEF的诊断价值。结果三组患者收缩压、舒张压、血浆白蛋白、胆固醇、低密度脂蛋白无显著性差异(P>0.05),而心率、总胆红素、同型半胱氨酸、血肌酐有明显差异(P<0.05);三组研究对象左室后壁厚度、每搏输出量无统计学意义(P>0.05),而左心室室间隔厚度、左室舒张末期前后径、左室收缩末期前后径、左室舒张末期容积中有显著差异(P<0.05);三组患者的血清NT-proBNP、sCD146水平有显著性差异(P<0.05),且HFmrEF患者的NT-proBNP、sCD146浓度均显著高于健康老年组患者;老年HFmrEF组与非老年HFmrEF组,sCD146与NT-proBNP、心功能分级呈正相关;sCD146诊断HFmr EF的曲线下面积为:0.945(95%CI:0.894,0.996),最佳截断值:68.459 ng/mL,灵敏度、特异度分别为:85.3%、93.5%。结论血清sCD146浓度在老年HFmrEF、非老年HfmrEF显著升高,sCD146对老年HFmrEF的诊断和病情评估有意义;老年HFmrEF患者血清sCD146与NT-proBNP、心功能分级具有相关性。Objective To detect the level of serum soluble CD146(sCD146)in elderly patients with heart failure(HFmrEF)and explore its clinical diagnostic value in elderly patients with HFmrEF.Methods From September,2020 to October,2021,34 elderly patients with heart failure(elderly HFmrEF group),34 non elderly patients with heart failure(non elderly HFmrEF group)and 31 healthy elderly patients(healthy elderly group)were selected from the Department of geriatrics and the Department of cardiovascular medicine of Hongqi Hospital Affiliated to Mudanjiang medical college.The data of age,sex,blood pressure,heart rate,total bilirubin,serum creatinine and cholesterol were collected.All patients were routinely examined by echocardiography to detect the levels of N-terminal precursor brain natriuretic peptide(NT-proBNP)and sCD146.The differences of general information,NT-proBNP,echocardiographic related indexes and sCD146 level of patients in each group were compared,and the correlation was analyzed.The diagnostic value of sCD146 for HFmrEF was evaluated by receiver operating characteristic curve(ROC).Results There was no significant difference in systolic blood pressure,diastolic blood pressure,plasma albumin,cholesterol and low-density lipoprotein among the three groups(P>0.05),but there were significant differences in heart rate,total bilirubin,homocysteine and serum creatinine(P<0.05);There was no significant difference in left ventricular posterior wall thickness and stroke output among the three groups(P>0.05),but there were significant differences in left ventricular septal thickness,left ventricular end diastolic anteroposterior diameter,left ventricular end systolic anteroposterior diameter and left ventricular end diastolic volume(P<0.05);The levels of NT-proBNP and sCD146 in serum of the three groups were significantly different(P<0.05),and the concentrations of NT-proBNP and sCD146 in HFmrEF patients were significantly higher than those in healthy elderly patients;sCD146 was positively correlated with NT-proBNP and cardiac

关 键 词：sCD146 NT-PROBNP 心功能分级 超声心动图相关指标 老年射血分数中间值心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]