慢性心力衰竭患者循环Endocan水平与心功能相关性及其对心血管主要终点事件的影响  

Correlation between endothelial cell specific molecule-1 and heart function and its influence on primary cardiovascular end-point events in patients with chronic heart failure

作　　者：王晓玲[1] 张立杰[1] 肖四海[1] 宋巧凤[1] 周文华[1] 王麟[1] 夏英杰[1] Wang Xiaoling;Zhang Lijie;Xiao Sihai;Song Qiaofeng;Zhou Wenhua;Wang Lin;Xia Yingjie(Department of Cardiology,People's Hospital of Tangshan City,Tangshan 063001,China;不详)

机构地区：[1]唐山市人民医院心内科,唐山063001

出　　处：《中国循证心血管医学杂志》2023年第3期302-305,310,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省卫生和计划生育委员会科研基金项目(20160868)。

摘　　要：目的探讨慢性心力衰竭(CHF)患者循环内皮细胞特异分子-1(Endocan)水平与心功能相关性及其对心血管主要终点事件的影响。方法选取2018年12月至2020年5月于唐山市人民医院心内科诊治的CHF患者193例。根据NYHA心功能分级分为Ⅱ级组、Ⅲ级组和Ⅳ级组,比较三组血清Endocan水平,分析Endocan与NYHA分级的相关性。患者均随访12个月,根据是否发生心血管主要终点事件分为事件组和无事件组,比较两组患者临床资料及血清Endocan水平;分析Endocan对CHF患者心血管主要终点事件的影响及预测价值。结果随访期间,193例CHF患者中失访5例(2.59%),最终共188例患者纳入研究;随访期间发生心血管主要终点事件者42例(22.34%)。NHYA分级Ⅳ级组患者血清Endocan水平高于Ⅲ级组、Ⅱ级组,且Ⅲ级组患者血清Endocan水平高于Ⅱ级组,差异有统计学意义(P<0.05)。Spearman等级相关分析显示,CHF患者Endocan与心功能NHYA分级呈正相关(r=0.255,P<0.05)。单因素分析显示:事件组与无事件组患者年龄、NHYA分级、左室射血分数(LVEF)、计算左室短轴缩短率(LVFS)比较,差异有统计学意义(P<0.05);且事件组患者N末端脑钠肽前体(NT-proBNP)、Endocan水平高于无事件组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:年龄≥65岁(OR=44.401,95%CI:3.302~597.057,P<0.01)、NHYA分级Ⅳ级(OR=12.703,95%CI:1.196~134.98,P<0.05)、NT-proBNP(OR=1.008,95%CI:1.004~1.012,P<0.01)、Endocan(OR=3.891,95%CI:1.529~9.898,P<0.01)是CHF患者发生心血管主要终点事件的危险因素,LVEF(OR=0.826,95%CI:0.709~0.961,P<0.05)是保护性因素。ROC曲线分析显示:血清Endocan预测CHF患者发生心血管主要终点事件的AUC为0.706(95%CI:0.614~0.798,P<0.05),预测敏感度为92.9%、特异度为47.9%。结论CHF患者血清Endocan与心功能存在相关性,Endocan与年龄、NHYA分级、LVEF、NT-pro BNP共同影响患者心血管主要终点事件的发生,且Endocan对心血管事�Objective To investigate the correlation between circulating level of endothelial cell specific molecule-1(Endocan)and heart function and its influence on primary cardiovascular end-point events in patients with chronic heart failure(CHF).Methods CHF patients(n=193)were chosen from Department of Cardiology in People’s Hospital of Tangshan City from Dec.2018 to May 2020.All patients were divided,according to NYHA classification,into gradeⅡgroup,gradeⅢgroup and gradeⅣgroup.The level of serum Endocan was compared,and correlation between Endocan and NYHA grade was analyzed in 3 groups.All patients were followed up for 12 months,and then they were divided,according to whether primary cardiovascular end-point events occurred or not,into event group and non-event group.The clinical materials and level of serum Endocan were compared between these 2 groups.The influence and predictive value of Endocan to primary cardiovascular end-point events in CHF patients were analyzed.Results During the follow-up period,5 patients(2.59%)of 193 CHF patients were missed in follow-up,and finally 188 patients were included in the study.There were 42 patients(22.34%)of 188 patients had primary cardiovascular end-point events during the follow-up period.The level of serum Endocan was higher in gradeⅣgroup than that in gradeⅡgroup and gradeⅢgroup,and level of serum Endocan was higher in gradeⅢgroup than that in grade II group(P<0.05).The results of Spearman rank correlation analysis showed that Endocan was positively correlated to NHYA grade(r=0.255,P<0.05)in CHF patients.The results of single-factor analysis showed that the differences in age,NHYA grades,LVEF and LVFS had statistical significance between event group and non-event group(P<0.05),and levels of NT-proBNP and Endocan were higher in event group than those in non-event group(P<0.05).The results of Logistic regression analysis showed that age≥65(OR=44.401,95%CI:3.302~597.057,P<0.01),gradeⅣof NHYA(OR=12.703,95%CI:1.196~134.98,P<0.05),NT-proBNP(OR=1.008,95%CI:1.0

关 键 词：慢性心力衰竭 内皮细胞特异分子-1 心功能 心血管事件 

分 类 号：R541.61[医药卫生—心血管疾病]