重症心力衰竭患者血清CXCL16、sST2水平变化及其与预后的关系  

Changes in serum CXCL16 and sST2 levels in patients with severe heart failure and the relationship with prognosis

作　　者：赵景宏[1] 乔彦[2] 张荣驿 邓建平[1] 陈勇[1] ZHAO Jinghong;QIAO Yan;ZHANG Rongyi;DENG Jianping;CHEN Yong(Department of Cardiology,the Second Clinical Medical College,North Sichuan Medical CollegeNanchong Central Hospital,Sichuan Province,Nanchong637000,China;Department of Endocrinolog,the Second Clinical Medical College,North Sichuan Medical CollegeNanchong Central Hospital,Sichuan Province,Nanchong637000,China)

机构地区：[1]川北医学院第二临床学院,四川省南充市中心医院心内科,四川南充637000 [2]川北医学院第二临床学院,四川省南充市中心医院内分泌科,四川南充637000

出　　处：《中国医药导报》2023年第2期56-59,共4页China Medical Herald

基　　金：四川省基层卫生事业发展、研究中心科研项目(SWFZ21-C-68)。

摘　　要：目的 探讨血清C-X-C基序趋化因子配体16(CXCL16)、可溶性致癌抑制因子2(s ST2)水平与重症心力衰竭(SHF)患者预后的关系。方法 选取2020年1月至2021年2月四川省南充市中心医院收治的168例SHF患者,根据预后情况分为死亡组41例和存活组127例。收集患者一般资料,采用酶联免疫吸附试验法测定血清CXCL16、s ST2水平。多因素logistic回归分析SHF患者死亡的影响因素,受试者操作特征曲线分析血清CXCL16、s ST2水平对SHF患者死亡的预测价值。结果 死亡组年龄大于存活组,病程长于存活组,纽约心脏协会分级Ⅳ级比例、血尿酸、B型钠尿肽、CXCL16、s ST2水平高于存活组,收缩压、左室射血分数低于存活组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,病程、纽约心脏协会分级、B型钠尿肽、CXCL16、s ST2为SHF患者死亡的独立危险因素,收缩压、左室射血分数为独立保护因素(P<0.05)。血清CXCL16、s ST2水平联合预测SHF患者死亡的曲线下面积大于血清CXCL16、s ST2单独预测(P<0.05)。结论 血清CXCL16、s ST2水平升高是SHF患者1年内死亡的独立危险因素,联合检测血清CXCL16、s ST2水平能提升SHF患者死亡的预测价值。Objective To investigate the relationship between serum C-X-C motif chemokine ligand 16(CXCL16) and soluble suppression of tumorigenicity 2(s ST2) levels and the prognosis of patients with severe heart failure(SHF).Methods A total of 168 patients with SHF admitted to Nanchong Central Hospital from January 2020 to February 2021 were selected and they were divided into 41 cases in the death group and 127 cases in the survival group according to their prognosis.General information of patients was collected and serum CXCL16 and s ST2 levels were measured by enzyme-linked immunosorbent assay.Multi-factor logistic regression was used to analyze the factors influencing death in SHF patients,and subject work characteristic curves were used to analyze the predictive value of serum CXCL16 and s ST2 levels on death in SHF patients.Results The age of death group was longer than that of survival group,and the course of disease was longer than that of survival group.The New York Heart Association grade Ⅳ ratio,blood uric acid,B-type natriuretic peptide,CXCL16,and s ST2 levels were higher than those of survival group,and systolic blood pressure and left ventricular ejection fraction were lower than those of survival group,with statistical significances(P<0.05).Multivariate logistic regression analysis showed that disease duration,New York Heart Association grade,B-type natriuretic peptide,CXCL16,and s ST2were independent risk factors for death in patients with SHF,while systolic blood pressure and left ventricular ejection fraction were independent protective factors(P<0.05).The area under the curve of the combined prediction of serum CXCL16 and s ST2 was greater than that of serum CXCL16 and s ST2 alone(P<0.05).Conclusion Elevated serum CXCL16and s ST2 levels are independent risk factors for death within one year in SHF patients.Combined testing of serum CXCL16 and s ST2 levels can enhance the predictive value of death in SHF patients.

关 键 词：重症心力衰竭 炎症 C-X-C基序趋化因子配体16 可溶性致癌抑制因子2 预后 

分 类 号：R542.2[医药卫生—心血管疾病]