血清脂质运载蛋白-2、网膜素-1水平与慢性心力衰竭患者心室重构及预后的相关性分析  

Correlation of serum LCN-2 and Omentin-1 levels with ventricular remodeling and prognosis in patients with chronic heart failure

作　　者：唐亮[1] 王其海[1] 朱坤[1] TANG Liang;WANG Qihai;ZHU Kun(Department of Cardiology,Anhui Wanbei Coal and Electricity Group General Hospital,Suzhou 234000,China)

机构地区：[1]安徽皖北煤电集团总医院心内一科,宿州234000

出　　处：《浙江医学》2022年第18期1941-1946,1955,共7页Zhejiang Medical Journal

摘　　要：目的探讨血清脂质运载蛋白-2(LCN-2)、网膜素-1水平与慢性心力衰竭(CHF)患者心室重构及预后的相关性。方法选择2018年1月至2021年1月安徽皖北煤电集团总医院收治的CHF患者121例,根据纽约心脏病协会(NYHA)心功能分级分为NYHAⅡ级组(30例)、NYHAⅢ级组(52例)、NYHAⅣ级组(39例),另择健康志愿者45名为对照组。检测并比较各组对象血清LCN-2、网膜素-1、炎性因子、心力衰竭指标、左心室重构参数。CHF患者出院后随访12个月,根据是否发生终点事件将患者分为预后良好亚组(39例)和预后不良亚组(82例)。采用多因素logistic回归分析影响CHF患者预后的因素,采用ROC曲线分析LCN-2、网膜素-1预测CHF患者预后的价值。结果NYHAⅡ级组、NYHAⅢ级组、NYHAⅣ级组血清LCN-2水平均高于对照组(均P<0.05),血清网膜素-1水平均低于对照组(均P<0.05)。血清LCN-2水平随着NYHA分级的增加而升高(P<0.05),血清网膜素-1水平则降低(P<0.05)。TNF-α、IL-6、B型脑钠肽(BNP),N末端B型脑钠肽前体(NT-proBNP)、左心室舒张末期内径(LVEDd)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室质量指数(LVMI)与血清LCN-2水平均呈正相关(r=0.872、0.752、0.753、0.892、0.754、0.760、0.773、0.905,均P<0.05),与血清网膜素-1水平均呈负相关(r=-0.869、-0.757、-0.768、-0.881、-0.759、-0.771、-0.753、-0.925,均P<0.05);LVEF与血清LCN-2水平呈负相关(r=-0.923,P<0.05),与血清网膜素-1水平呈正相关(r=0.907,P<0.05)。NYHA分级Ⅳ级、LCN-2是CHF患者预后不良的危险因素,网膜素-1是CHF患者预后不良的保护因素(P<0.05)。联合LCN-2、网膜素-1预测CHF患者预后不良的AUC为0.909,均高于单独LCN-2、网膜素-1的AUC 0.745、0.701(均P<0.05)。结论LCN-2水平升高、网膜素-1水平降低与心室重构和不良预后有关,可作为CHF患者预后评估的辅助指标。Objective To investigate the association of serum lipocalin-2(LCN-2)and Omentin-1 levels with ventricular remodeling and prognosis in patients with chronic heart failure(CHF).Methods One hundred and twenty one patients with CHF were enrolled in the study,according to New York Heart Association(NYHA)criteria patients were classified as NYHAⅡgroup(30 cases),NYHAⅢgroup(52 cases)and NYHAⅣgroup(39 cases);meanwhile 45 healthy volunteers were selected as the control group.Serum LCN-2,Omentin-1,inflammatory factors and biological indicators of heart failure were detected,and left ventricular remodeling parameters were obtained by echocardiography.Patients with CHF were followed up for 12 months after discharge,and were divided into good prognosis group(39 cases)and poor prognosis group(82 cases)according to the occurrence of end point event.The prognostic factors in patients with CHF and the prognostic value of LCN-2 and Omentin-1 in patients with CHF were analyzed.Results The serum LCN-2 level of NYHAⅡgroup,NYHAⅢgroup and NYHAⅣgroup was higher than that of control group(P<0.05),and the serum Omentin-1 level was lower than that of control group(P<0.05).The serum LCN-2 level was increased with the increase of NYHA grade(P<0.05),while the serum omentin-1 level was decreased(P<0.05).Serum LCN-2 levels were positively correlated with tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),B-type natriuretic peptide(BNP),N-terminal B-type brain natriuretic peptide(NT-proBNP),left ventricular end-diastolic diameter(LVEDd),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),left ventricular mass index(LVMI)(r=0.872,0.752,0.753,0.892,0.754,0.760,0.773and 0.905,P<0.05);and negatively correlated with left ventricular ejection fraction(LVEF)(r=-0.923,P<0.05).Serum Omentin-1 level was negatively correlated with TNF-α,IL-6,BNP,NT-proBNP,LVEDD,LVPWT,IVST and LVMI(r=-0.869,-0.757,-0.768,-0.881,-0.759,-0.771,-0.753 and-0.925,P<0.05);and positively correlated with LVEF(r=0.907,P<0.05).The se

关 键 词：脂质运载蛋白-2 网膜素-1 心力衰竭 心室重构 

分 类 号：R541.6[医药卫生—心血管疾病]