心力衰竭患者血清MMP-9、LPO、cathepsin S水平检测及其临床意义  

Detection of serum matrix metalloproteinase-9,lipid peroxide,and cathepsin S levels in patients with heart failure and its clinical significance

作　　者：张雯艳 华玮 居培红 李铮 黄侃 ZHANG Wen-yan;HUA Wei;JU Pei-hong;LI Zheng;HUANG Kan(Department of Emergency,Yangpu Hospital Affiliated to Tongji University,Shanghai 200090,CHINA)

机构地区：[1]同济大学附属杨浦医院急诊科,上海200090

出　　处：《海南医学》2023年第17期2532-2535,共4页Hainan Medical Journal

基　　金：上海市杨浦区中心医院2020年度院级课题立项(编号:Se1202003)。

摘　　要：目的研究心力衰竭患者血清基质金属蛋白酶9(MMP-9)、脂质过氧化物(LPO)、组织蛋白酶S(cathepsin S)水平变化及其临床意义。方法选取2021年3月至2022年3月期间同济大学附属杨浦医院收治的50例心衰患者作为研究组,根据NYHA心功能分级分为Ⅰ~Ⅳ级,其中Ⅰ级10例、Ⅱ级13例、Ⅲ级11例、Ⅳ级16例,另选取我院同期体检健康者50例作为对照组。比较两组受检者及不同NYHA分级患者的血清MMP-9、LPO、cathepsin S水平,采用受试者工作特征曲线(ROC)分析各指标对心衰的诊断价值。结果研究组患者的血清MMP-9、LPO、cathepsin S水平分别为(564.56±28.43)ng/mL、(13.38±0.23)μmol/L、(8.56±0.78)U/L,明显高于对照组的(108.56±27.54)ng/mL、(9.48±0.42)μmol/L、(4.75±0.46)U/L,差异均有统计学意义(P<0.05);不同NYHA分级患者的血清MMP-9、LPO、cathepsin S水平比较差异均有统计学意义(P<0.05),且NYHA分级越高患者的血清MMP-9、LPO、cathepsin S水平越高;MMP-9、LPO、cathepsin S各指标对心衰均具有一定的诊断价值,联合诊断的准确度最高,为93.48%,三个指标中MMP-9的特异性与灵敏度均最高,分别为81.62%、84.28%,但cathepsin S的准确度最高,为86.24%。结论心力衰竭患者血清MMP-9、LPO、cathepsin S水平均明显升高,且NYHA分级越高,三项指标水平也越高,在临床上可作为评估心衰严重程度的重要指标。Objective To study the changes of serum levels of matrix metalloproteinase-9(MMP-9),lipid peroxide(LPO),and cathepsin S in patients with heart failure and its clinical significance.Methods Fifty patients with heart failure admitted to Yangpu Hospital Affiliated to Tongji University from March 2021 to March 2022 were selected as the study group.According to NYHA cardiac function classification,they were divided into gradesⅠ-Ⅳ,including 10 cases of gradeⅠ,13 cases of gradeⅡ,11 cases of gradeⅢ,and 16 cases of gradeⅣ.Fifty healthy people who underwent physical examination in the hospital during the same period were selected as the control group.The serum levels of MMP-9,LPO,and cathepsin S were compared between two groups of subjects and among patients with different NYHA grades,and the diagnostic value of each indicator for heart failure were analyzed by the receiver operating characteristic curve(ROC).Results The levels of serum MMP-9,LPO,and cathepsin S in the study group were(564.56±28.43)ng/mL,(13.38±0.23)μmol/L,and(8.56±0.78)U/L,which were significantly higher than(108.56±27.54)ng/mL,(9.48±0.42)μmol/L,and(4.75±0.46)U/L in the control group(P<0.05).There were significant differences in serum MMP-9,LPO,and cathepsin S levels among patients with different NYHA grades(P<0.05),and the higher the NYHA grade,the higher the serum MMP-9,LPO,and cathepsin S levels.The indexes of MMP-9,LPO,and cathepsin S had certain diagnostic value for heart failure.The accuracy of combined detection of the three indexes was the highest,which was 93.48%.For single detection of each index,the specificity and sensitivity of MMP-9 were the highest,which were 81.62%and 84.28%,respectively,but the accuracy of cathepsin S was the highest,which was 86.24%.Conclusion The serum levels of MMP-9,LPO,and cathepsin S in patients with heart failure were significantly increased,and the higher the NYHA grade,the higher the three indicators level,which can be used as important indicators to evaluate the severity of heart failure in c

关 键 词：心力衰竭 基质金属蛋白酶-9 过氧化脂质 组织蛋白酶S 诊断 

分 类 号：R541.6[医药卫生—心血管疾病]