血清NT-proBNP、syndecan-4、PⅢ-NP与急性心力衰竭患者心功能、心室重构及预后的相关性  

Correlation of NT-proBNP,syndecan-4,PⅢ-NP levels with cardiac function,ventricular remodeling and prognosis in patients with acute heart failure

作　　者：陈继兴 陈世雄 唐庆业 陈清华 CHEN Jixing;CHEN Shixiong;TANG Qingye;CHEN Qinghua(Department of Cardiovascular Medicine,Danzhou People′s Hospital,Danzhou,Hainan 571799,China)

机构地区：[1]儋州市人民医院心血管内科,海南儋州571799

出　　处：《国际检验医学杂志》2023年第2期222-226,共5页International Journal of Laboratory Medicine

基　　金：海南省卫生计生行业科研项目(18A200070)。

摘　　要：目的研究急性心力衰竭(AHF)患者血清N末端前体脑利钠肽(NT-proBNP)、多配体蛋白聚糖-4(syndecan-4)、Ⅲ型前胶原氨基端原肽(PⅢ-NP)的表达水平与其心功能、心室重构及预后之间的相关性。方法选取于该院2019年1月至2020年12月就诊的97例AHF患者作为研究组,取同期体检健康者63例作为对照组。根据随访预后情况将97例AHF患者分为预后良好组(未发生心血管不良事件)68例和预后不良组(发生心血管不良事件)29例。分别对比研究组与对照组,预后良好组与预后不良组的血清NT-proBNP、syndecan-4及PⅢ-NP的表达水平;采用纽约心脏病学会(NYHA)分级评价患者心功能情况并对比不同分级下患者血清NT-proBNP、syndecan-4及PⅢ-NP的表达水平;超声心动仪检测并对比研究组和对照组心室重构指标;分析血清NT-proBNP、syndecan-、PⅢ-NP与AHF患者心功能、心室重构及其预后之间相关性。结果研究组患者血清NT-proBNP、syndecan-4、PⅢ-NP表达水平均明显高于对照组,两组对比差异具有统计学意义(P<0.05)。采用NAHY心功能分级将97例AHF患者分为Ⅱ级29例,Ⅲ级44例,Ⅳ级24例,各分级下的NT-proBNP、syndecan-4、PⅢ-NP水平对比结果为:Ⅳ级>Ⅲ级>Ⅱ级,各组对比差异具有统计学意义(P<0.05)。研究组的LVEF小于对照组,左心室舒张末期内径(LVEDD)、左心房内径(LAD)及左心室质量指数(LVMI)显著大于对照组,两组比较差异具有统计学意义(P<0.05)。预后不良组心衰患者血清NT-proBNP、syndecan-4、PⅢ-NP的表达水平均明显高于预后良好组,两组比较差异具有统计学意义(P<0.05)。经Spearman相关性分析可知,NT-proBNP、syndecan-4、PⅢ-NP水平与AHF患者左心室重构功能指标LVEDD、LAD、LVMI、NAHY分级均呈正相关(P<0.05),与LVEF和预后情况呈负相关(P<0.05)。结论AHF患者血清中的NT-proBNP、syndecan-4、PⅢ-NP水平与AHF患者的NYHA心功能分级、左心室重构以及预后情况均Objective To investigate the correlation between the expression levels of serum N-terminal pro-brain natriuretic peptide(NT-proBNP),multi-ligand proteoglycan-4(syndecan-4)andⅢprocollagen amino-terminal peptide(PⅢ-NP)and cardiac function,ventricular remodeling and prognosis in patients with acute heart failure(AHF).Methods Ninety-seven patients with AHF admitted to Danzhou People′s Hospital from January 2019 to December 2020 were selected as the study group,and 63 healthy volunteers who underwent physical examination in the same period were selected as the control group(n=63).Ninety-seven patients with AHF were further divided into a good prognosis group(without cardiovascular adverse events)(n=68)and a poor prognosis group(with cardiovascular adverse events,n=29)according to the follow-up prognosis.The expression levels of serum NT-proBNP,syndecan-4 and PⅢ-NP were compared between the study group and the control group,and between the good prognosis group and the poor prognosis group,respectively.New York Heart Association(NYHA)classification was used to evaluate the cardiac function of the patients and the expression levels of serum NT-proBNP,syndecan-4 and PⅢ-NP were compared between the patients with different grades.Echocardiography was used to detect and compare the ventricular remodeling parameters between the study group and the control group;and the correlation between serum NT-proBNP,syndecan-4,PⅢ-NP and cardiac function,ventricular remodeling and their prognosis in patients with acute heart failure was analyzed.Results The expression levels of NT-proBNP,syndecan-4 and PⅢ-NP in the study group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).Ninety-seven patients with AHF were divided into gradeⅡ(n=29),gradeⅢ(n=44)and gradeⅣ(n=24)by NAHY functional classification.The levels of NT-proBNP,syndecan-4 and PⅢ-NP in each grade were in such sequence:gradeⅣ>gradeⅢ>gradeⅡ;There was significant difference between the groups(P<

关 键 词：心力衰竭 急性 纽约心脏病学会分级 左室重构 预后 

分 类 号：R541.6[医药卫生—心血管疾病]