血清FGF-21 IL-13 sVEGFR-2与急性心力衰竭患者短期预后的关系  

The relationship of serum FGF-21 IL-13 and sVEGFR-2 with short-term prognosis in the patients with acute heart failure

作　　者：姜颖 覃念 李玉慈 Jiang Ying;Qin Nian;Li Yu-ci(Department of Cardiovascular Medicine,Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,China)

机构地区：[1]恩施土家族苗族自治州中心医院心血管内科,湖北恩施445000

出　　处：《中国急救医学》2023年第1期43-48,共6页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨血清成纤维细胞生长因子-21(FGF-21)、白细胞介素-13(IL-13)、可溶性血管内皮生长因子受体-2(sVEGFR-2)水平与急性心力衰竭患者短期预后的相关性。方法 选取2019年1月至2020年12月在我院接受治疗的急性心力衰竭患者136例作为心力衰竭组。选取同期在我院健康体检者80例作为健康对照组。采用ELISA法检测血清FGF-21、IL-13、sVEGFR-2水平。随访1年,根据急性心力衰竭患者有无不良心血管事件发生分为预后良好组和预后不良组,并分析影响患者1年内临床结局的危险因素。采用ROC曲线,分析FGF-21、IL-13、sVEGFR-2对急性心力衰竭患者预后不良的诊断效能。结果 心力衰竭组血清FGF-21、IL-13高于健康对照组[FGF-21(pg/mL):74.81±16.29 vs. 19.37±5.11, IL-13(pg/mL):5.14±1.23 vs.1.62±0.54,P<0.001]、sVEGFR-2低于健康对照组(ng/mL:6.30±1.57 vs.15.18±4.29,P<0.05)。预后不良组血清FGF-21、IL-13、NT-proBNP分别高于预后良好组[FGF(pg/mL):92.31±20.84 vs.67.52±13.70, IL-13(pg/mL):6.94±1.75 vs.4.39±1.18, NT-proBNP(ng/L):4689.16±132.50 vs.2120.59±51.48],LVEF值、血清sVEGFR-2低于预后良好组[LVEF(%):45.27±6.13 vs.53.95±7.80, sVEGFR(ng/mL):4.85±1.24 vs.6.98±2.31,P<0.05]。多因素Logistic回归分析结果显示,LVEF(95%CI 0.265~0.840,P<0.001)及血清NT-proBNP(95%CI 1.002~2.317,P=0.015)、FGF-21(95%CI 1.438~5.019,P<0.001)、IL-13(95%CI 1.027~3.165,P=0.006)、sVEGFR-2(95%CI 1.190~4.283,P=0.002)是影响急性心力衰竭患者不良预后的独立危险因素。ROC曲线结果显示,血清FGF-21、IL-13、sVEGFR-2及三项联合检测预测急性心力衰竭患者不良预后的曲线下面积分别为0.810、0.775、0.821、0.918。结论 血清FGF-21、IL-13、sVEGFR-2水平与急性心力衰竭患者NYHA分级及临床预后密切相关,联合检测血清FGF-21、IL-13、sVEGFR-2对评估患者不良预后有较高参考价值。Objective To investigate the relationship of serum fibroblast growth factor-21(FGF-21), interleukin-13(IL-13) and soluble vascular endothelial growth factor receptor-2(sVEGFR-2) levels and short-term prognosis in the patients with acute heart failure. Methods A total of 136 patients with acute heart failure who were treated in our hospital from January 2019 to December 2020 were selected as the research subjects(heart failure group). During the same period, another 80 healthy subjects in our hospital were selected as the healthy control group. Serum FGF-21, IL-13 and sVEGFR-2 levels were detected by ELISA. With one-year follow-up, according to the occurrence of adverse cardiovascular events, the patients with acute heart failure were divided into a good prognosis group and a poor prognosis group, and the risk factors affecting the clinical outcome of the patients within one year were analyzed. The ROC curve was used to analyze the diagnostic efficacy of FGF-21, IL-13 and sVEGFR-2 for poor prognosis in the patients with acute heart failure. Results The levels of serum FGF-21 and IL-13 in the heart failure group were significantly higher than those in the control group[FGF-21(pg/mL): 74.81±16.29 vs. 19.37±5.11,IL-13(pg/mL): 5.14 ±1.23 vs.1.62±0.54, P<0.001], and sVEGFR-2 was lower in the heart failure group than in the control group(ng/mL:6.30 ±1.57 vs.15.18 ±4.29,P<0.05). The serum levels of FGF-21, IL-13 and NT-proBNP in the poor prognosis group were higher than those in the good prognosis group[FGF(pg/mL):92.31±20.84 vs. 67.52±13.70, IL-13(pg/mL):6.94 ±1.75 vs.4.39 ±1.18,NT-proBNP(ng/L):4689.16 ±132.50 vs.2120.59 ±51.48],while the LVEF value and serum sVEGFR-2 level were lower than those in the good prognosis group[LVEF(%):45.27±6.13 vs. 53.95±7.80, sVEGFR-2(ng/mL):4.85 ±1.24 vs. 6.98 ±2.31, P<0.05]. Multivariate Logistic regression analysis showed that LVEF(95%CI 0.265-0.840, P<0.001), serum NT-proBNP(95%CI 1.002-2.317, P=0.015), FGF-21(95%CI 1.438-5.019, P<0.001), IL-13(95%CI 1.027-3.165, P=0.0

关 键 词：成纤维细胞生长因子-21(FGF-21) 白细胞介素-13(IL-13) 可溶性血管内皮生长因子受体-2(sVEGFR-2) 急性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]