慢性心力衰竭患者血清sICAM-1、Lp-PLA2、CatS的表达水平及对近期预后的预测价值  

Expression levels of serum soluble intercellular adhesion molecule-1,lipoprotein associated phospholipase A2 and protease S and their predictive value to short-term prognosis in patients with chronic heart failure

作　　者：陈刚[1] 信鹏程 陈文宽[1] 陈红卫[1] Chen Gang;Xin Pengcheng;Chen Wenkuan;Chen Hongwei(Department of Cardiac Surgery,Seventh People's Hospital of Zhengzhou City,Zhengzhou 450000,China.;不详)

机构地区：[1]郑州市第七人民医院心外科,郑州450000 [2]郑州市第七人民医院心血管内科,郑州450000

出　　处：《中国循证心血管医学杂志》2023年第2期210-212,217,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨慢性心力衰竭(心衰)患者血清可溶性细胞黏附分子-1(sICAM-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)、蛋白酶S(CatS)的表达水平及对近期预后的预测价值。方法选择2021年1月至2022年6月于郑州市第七人民医院心内科就诊的85例慢性心衰患者作为研究对象(病例组),另选取我院同期体检的健康人群80例为对照组,分析两组患者血清sICAM-1、Lp-PLA2、CatS水平变化及对近期预后的预测价值。结果病例组患者血清sICAM-1、Lp-PLA2、CatS水平显著高于对照组,差异有统计学意义(P<0.05);NYHA分级心功能Ⅱ级患者血清sICAM-1、Lp-PLA2、CatS水平显著低于心功能Ⅲ级、Ⅳ级患者,心功能Ⅲ级患者血清sICAM-1、Lp-PLA2、CatS水平显著低于心功能Ⅳ级患者,差异有统计学意义(P<0.05);预后不良组患者血清sICAM-1、Lp-PLA2、CatS水平显著高于预后良好组,差异有统计学意义(P<0.05)。ROC曲线分析显示,血清sICAM-1预测慢性心衰预后的AUC为0.944,灵敏度为78.30%,特异度为87.10%,截断值为568.44μg/L;血清Lp-PLA2预测慢性心衰预后的AUC为0.974,灵敏度为71.00%,特异度为92.90%,截断值为74.23 ng/ml;血清CatS预测慢性心衰预后的AUC为0.818,灵敏度为63.10%,特异度为70.60%,截断值为57.61 ng/ml(P<0.05)。结论慢性心衰患者中血清sICAM-1、Lp-PLA2、CatS表达异常,与病情程度关系密切,可作为评估预后的指标之一。Objective To investigate the expression levels of serum soluble intercellular adhesion molecule-1(sICAM-1),lipoprotein associated phospholipase A2(Lp-PLA2)and protease S(CatS)and their predictive value to short-term prognosis in patients with chronic heart failure(CHF).Methods CHF patients(n=85)were chosen into case group from the Seventh People’s Hospital of Zhengzhou City from Jan.2021 to June 2022,and at the same time the healthy controls with physical examinations(n=80)were chosen into control group.The changes and predictive value to prognosis of sICAM-1,Lp-PLA2 and CatS were analyzed in 2 groups.Results The levels of serum sICAM-1,Lp-PLA2 and CatS were significantly higher in case group than those in control group(P<0.05).The levels of serum sICAM-1,Lp-PLA2 and CatS were significantly lower in patients with NYHA grade II than those in patients with NYHA grades III and IV,and were significantly lower in patients with NYHA III than those in patients with NYHA grade IV(P<0.05).The levels of serum sICAM-1,Lp-PLA2 and CatS were significantly higher in patients with poor prognosis than those in patients with good prognosis(P<0.05).The results of ROC curve analysis showed that AUC of sICAM-1 was 0.944,sensitivity was 78.30%,specificity was 87.10%and cutoff value was 568.44μg/L in predicting CHF,AUC of Lp-PLA2 was 0.974,sensitivity was 71.00%,specificity was 92.90%and cutoff value was 74.23 ng/ml,and AUC of CatS was 0.818,sensitivity was 63.10%,specificity was 70.60%and cutoff value 57.61 g/mL(P<0.05).Conclusion The expressions of serum sICAM-1,Lp-PLA2 and CatS are abnormal in CHF patients,which is closely related to disease conditions and can be taken as an index for reviewing prognosis.

关 键 词：慢性心力衰竭 可溶性细胞黏附分子-1 脂蛋白相关磷脂酶A2 蛋白酶S 预测价值 

分 类 号：R541.61[医药卫生—心血管疾病]