老年心力衰竭患者血清NF-κB,Gal-3和sST2水平联合检测与预后评估价值  

Prognostic Value of Combined Serum NF-κB,Gal-3 and sST2 Levels in Elderly Patients with Heart Failure

作　　者：王勇 张克波[1] WANG Yong;ZHANG Ke-bo(Department of Clinical Laboratory,Guangyuan Mental Health Center,Sichuan Guangyuan 628000,China)

机构地区：[1]广元市精神卫生中心检验科,四川广元628000

出　　处：《现代检验医学杂志》2022年第5期148-153,共6页Journal of Modern Laboratory Medicine

基　　金：保定市科技局社发类项目:高龄心力衰竭患者常见合并症及其干预措施的研究(编号:1941ZF029)。

摘　　要：目的 探讨老年心力衰竭(heart failure,HF)患者血清核因子-κΒ(nuclear factor-κΒ,NF-κΒ)、半乳糖凝集素3(galectin 3,Gal-3)和可溶性生长刺激表达基因2(soluble growth-stimulating expression gene 2,s ST2)蛋白水平联合检测与预后评估价值。方法 选取广元市精神卫生中心2018年1月~2019年12月收治的100例HF患者为HF组,随访一年根据预后情况分为预后不良组(n=52)和预后良好组(n=48),另选取同期60例体检健康者为对照组。酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测血清NF-κΒ,Gal-3和s ST2水平。比较HF组和对照组血清NF-κΒ,Gal-3和s ST2水平,并比较不同纽约心脏协会(New York Heart Association Classification,NYHA)心功能分级HF组血清NF-κΒ,Gal-3和s ST2水平。多因素Logistic回归分析老年HF患者预后不良影响因素,ROC曲线分析血清NF-κΒ,Gal-3和s ST2水平对老年HF患者预后的评估价值。结果 HF组血清NF-κΒ,Gal-3和s ST2水平(25.15±6.37pg/ml,104.96±26.11ng/L,1 117.80±494.96pg/ml)高于对照组(16.56±4.14pg/ml,74.71±15.05ng/L,584.00±191.50pg/ml),差异均有统计学意义(t=9.321,8.189,7.994,均P<0.001)。Ⅲ~Ⅳ级老年HF患者血清NF-κΒ,Gal-3和s ST2水平(28.30±5.71pg/ml,113.75±25.24ng/L,1 346.99±468.64pg/ml)高于Ⅰ~Ⅱ级(22.57±5.73pg/ml,97.77±24.78ng/L,930.29±436.59pg/ml),差异均有统计学意义(t=-4.983,-3.182,-4.594,均P<0.001)。随访一年,100例HF患者预后不良52例。多因素Logistic回归分析显示,NYHA心功能分级Ⅲ~Ⅳ级、高血清氨基末端脑钠肽前体(N terminal pro B type natriuretic peptide,NT-pro BNP),NF-κΒ,Gal-3和s ST2水平为老年HF患者预后不良独立危险因素(OR=1.003~8.653,均P<0.05)。ROC曲线显示,NF-κΒ,Gal-3,s ST2和NF-κΒ+Gal-3+s ST2评估老年HF患者不良预后的曲线下面积分别为0.804,0.747,0.776和0.882,NF-κΒ+Gal-3+s ST2评估老年HF患者不良预后的曲线下面积大于各指标单独预测(Z=2.173~3.177,均P<0.05)。结论 老年HF患者Objective To investigate the value of combined serum nuclear factor-κΒ(NF-κΒ),galectin 3(Gal-3)and soluble growth-stimulating expression gene 2(sST2)protein levels in elderly patients with heart failure(HF)and prognostic assessment.Methods A total of 100 HF patients admitted to Guangyuan Mental Health Center(January 2018 to December 2019)were selected as the HF group,and they were divided into a poor prognosis group(n=52)and a good prognosis group(n=48)according to the prognosis for 1 year,and another 60 healthy persons undergoing physical examination during the same period were selected as control group.Serum NF-κΒ,Gal-3 and sST2 levels were measured by enzyme-linked immunosorbent assay(ELISA).Serum NF-κΒ,Gal-3 and sST2 levels were compared between the HF and control groups,and serum NF-κΒ,Gal-3 and sST2 levels were compared between different New York Heart Association(NYHA)cardiac function classes in the HF group.Multi-factor logistic regression was used to analyze factors influencing poor prognosis in elderly HF patients,and ROC curves were used to analyze the value of serum elderly NF-κΒ,Gal-3 and sST2 levels in assessing the prognosis of elderly HF patients.Results The serum NF-κB,Gal-3 and sST2 levels in the HF group(25.15±6.37 pg/ml,104.96±26.11ng/L,1117.80±494.96pg/ml)were significantly higher than those in the control group(16.56±4.14 pg/ml,74.71±15.05ng/L,584.00±191.50 pg/ml)and the differences were statistically significant(t=9.321,8.189,7.994,allP<0.001).The serum NF-κB,Gal-3 and sST2 levels of elderly HF patients of grade Ⅲ~Ⅳ(28.30±5.71pg/ml,113.75±25.24ng/L,1 346.99±468.64pg/ml)were significantly higher than those of grad e Ⅰ~Ⅱ(22.57±5.73 pg/ml,97.77±24.78ng/L,930.29±436.59 pg/ml),and the differences were statistically significant(t=-4.983,-3.182,-4.594,all P<0.001).At one year follow-up,52 of 100 HF patients had poor prognosis.Multi-factorial logistic regression analysis showed that NYHA cardiac function class III~IV,high serum amino-terminal pro B type natriuretic

关 键 词：老年心力衰竭 核因子-κΒ 半乳糖凝集素3 可溶性生长刺激表达基因2蛋白 

分 类 号：R541.6[医药卫生—心血管疾病] R392.11[医药卫生—内科学]