基于简易危险分层探索血清sST2评估结缔组织病相关肺动脉高压病情严重程度的研究  

The role of sST2 in evaluating the severity of connective tissue disease associated pulmonary arterial hypertension based on simplified risk stratification

作　　者：甘晓霞 叶黄戍 王嫱[2] 孙晓萱[2] GAN Xiaoxia;YE Huangshu;WANG Qiang;SUN Xiaoxuan(Department of Geriatrics,the Affiliated Geriatric Hospital of Nanjing Medical University,Nanjing 210024;Department of Rheumatology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属老年医院老年医学科,江苏南京210024 [2]南京医科大学第一附属医院风湿免疫科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2023年第9期1223-1229,共7页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81701610,82071827);江苏省人民医院临床能力提升工程(JSPH-MC-2021-09);南京医科大学科技发展基金一般项目(NMUB2018174);江苏省干部保健科研项目(BJ21028)。

摘　　要：目的:基于简易危险分层探索血清可溶性生长刺激表达基因2(soluble growth stimulation expressed gene 2,sST2)蛋白水平在评估结缔组织病相关肺动脉高压(connective tissue disease associated pulmonary arterial hypertension,CTD-PAH)病情严重程度中的价值。方法:回顾性分析2017年1月—2021年11月在南京医科大学第一附属医院风湿免疫科由右心导管诊断的48例CTD-PAH患者临床资料。收集患者基线及随访资料:血清sST2水平、人口统计学资料、原发病和PAH临床特征资料、治疗方案。根据2018世界肺高压大会上发布的简易危险分层量表评估所有患者基线时危险分层水平。采用Pearson相关分析和线性回归分析评价sST2水平与CTD-PAH临床基线资料之间的相关性;采用受试者工作特征(receiver operating characteristics,ROC)曲线分析,确定基线sST2水平区分中高危CTD-PAH患者的最佳阈值。结果:中高危患者的血清sST2水平显著高于低危患者[45.97(30.24,75.68)ng/mL vs.29.36(20.89,41.25)ng/mL,P=0.006]。ROC曲线分析提示sST2≥45.56 ng/mL可以识别中高危CTD-PAH患者,灵敏度和特异度分别为56%和91%。结论:血清sST2水平与CTD-PAH患者病情严重程度相关,中高危患者血清中sST2水平明显高于低危患者。sST2可作为CDT-PAH患者的预后生物标志物。Objective:The current study aims to explore the role of serum soluble growth stimulation expressed gene 2(sST2)in evaluating the severity of connective tissue disease associated pulmonary arterial hypertension(CTD⁃PAH)based on simplified risk stratification.Methods:A total of 48 patients with CTD⁃PAH diagnosed by right heart catheterization(RHC)were included from the Departments of Rheumatology,the First Affiliated Hospital of Nanjing Medical University between Jan 2017 and Nov 2021.Baseline clinical evaluation,laboratory index,RHC parameters and treatment regimen were collected.Pearson and analysis linear regression were used for the correlation between clinical characteristics of CTD⁃PAH and sST2 level.A receiver operating characteristics(ROC)curve assessed the diagnostic value of sST2 in assessing low risk and intermediate⁃high risk CTD⁃PAH patients.Results:CTD⁃PAH patients in intermediate⁃high risk group was higher in sST2 level than low risk group[45.97(30.24,75.68)ng/mL vs.29.36(20.89,41.25)ng/mL,P=0.006].ROC curve analysis showed that sST2≥45.56 ng/mL could identify intermediate⁃high risk CTD⁃PAH patients with a sensitivity and specificity of 56%and 91%,respectively.Conclusion:The sST2 is significantly associated with parameters that can reflect disease severity of CTD⁃PAH,and the sST2 level is signficantly higher in intermediate⁃high risk group than in low risk group.The measurement of sST2 may serve as a prognostic biomarker of CTD⁃PAH patients.

关 键 词：可溶性生长刺激表达基因2 结缔组织病 肺动脉高压 简易危险分层 

分 类 号：R593.2[医药卫生—内科学]