血清PTEN、CD34和NT-proBNP在老年心力衰竭早期诊断及预后评估中的应用  

Application of serum PTEN,CD34,and NT-proBNP in the early diagnosis and prognosis evaluation of elderly heart failure

作　　者：刘青 赵志杰 刘仁富 李鹏飞 张媛媛 Liu Qing;Zhao Zhijie;Liu Renfu;Li Pengfei;Zhang Yuanyuan(Department of Emergency,Cangzhou People's Hospital,Hebei Province,Cangzhou 061000,China;不详)

机构地区：[1]沧州市人民医院检验科,061000 [2]沧州市人民医院急诊科,061000

出　　处：《疑难病杂志》2023年第11期1143-1147,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省卫生健康委科研项目(20220323)。

摘　　要：目的探究血清同源性磷酸酯酶—张力蛋白(PTEN)、白细胞分化抗原34(CD34)、氨基末端脑钠尿肽(NT-proBNP)对老年心力衰竭(HF)早期诊断及预后的评估价值。方法选取2020年9月—2022年11月沧州市人民医院急诊科收治老年HF患者126例为研究对象(HF组),根据纽约心脏协会(NYHA)心功能分级分为心功能Ⅰ级亚组(n=29),Ⅱ级亚组(n=40),Ⅲ级亚组(n=32)和Ⅳ级亚组(n=25),依据预后状况将患者分为预后良好亚组(n=76)和预后不良亚组(n=50);另选取同期在医院健康体检者50例为健康对照组。比较各组血清PTEN、CD34、NT-proBNP水平;Logistic回归分析老年HF患者预后不良的影响因素;受试者工作特征曲线(ROC)分析血清PTEN、CD34、NT-proBNP对老年HF患者预后的评估价值。结果与健康对照组比较,HF组患者血清PTEN水平降低(t/P=13.809/<0.001),CD34、NT-proBNP水平升高(t/P=10.462/<0.001,24.509/<0.001);血清PTEN、CD34和NT-proBNP水平随着NYHA分级的增加,血清PTEN水平逐渐降低(F/P=57.753/<0.001),CD34和NT-proBNP水平逐渐增高(F/P=27.626/<0.001,111.566/<0.001);预后良好亚组与预后不良亚组患者在性别、年龄、BMI、高血压、糖尿病、LVEDD比较差异无统计学意义(P>0.05),预后良好亚组患者LVEF、PTEN水平显著高于预后不良亚组(t/P=29.827/<0.001,7.566/<0.001),CD34、NT-proBNP水平显著低于预后不良亚组(t/P=9.846/<0.001,12.801/<0.001);Logistic回归分析显示,NYHA分级Ⅲ~Ⅳ、PTEN低、CD34高和NT-proBNP高是影响老年HF患者预后不良的危险因素[OR(95%CI)=2.011(1.251~3.232)、1.986(1.278~3.087)、2.022(1.271~3.218)、1.533(1.075~2.186)];ROC曲线结果显示,血清PTEN、CD34、NT-proBNP及三者联合评估老年HF患者预后的AUC分别为0.849、0.915、0.925、0.979,三者联合评估的AUC大于单源检测(Z/P=3.479/0.001、2.462/0.014、2.077/0.038)。结论老年HF患者血清PTEN水平显著降低,CD34、NT-proBNP水平显著升高,三者与老年HF患者NYHA心功能分级�Objective To explore the value of serum homologous phosphatase tensin(PTEN),leukocyte differentiation antigen 34(CD34),and amino terminal brain natriuretic peptide(NT-proBNP)in the early diagnosis and prognosis of elderly heart failure(HF).Methods One hundred and twenty-six elderly HF patients admitted to the Emergency Department of Cangzhou People's Hospital from September 2020 to November 2022 were selected as the study subjects(HF group).According to the New York Heart Association(NYHA)cardiac function classification,they were divided into a Class Ⅰ subgroup(n=29),a Class Ⅱ subgroup(n=40),a Class Ⅲ subgroup(n=32),and a Class IV subgroup(n=25).Patients were divided into a Good Prognostic subgroup(n=76)and a Poor Prognostic subgroup(n=50)based on their prognosis;Another 50 healthy individuals who underwent physical examination in the hospital during the same period were selected as the healthy control group.Compare the serum PTEN,CD34,and NT-proBNP levels in each group;Logistic regression analysis of the influencing factors of poor prognosis in elderly HF patients;The evaluation value of receiver operating characteristic curve(ROC)analysis of serum PTEN,CD34,and NT-proBNP in the prognosis of elderly HF patients.Results Compared with the healthy control group,the serum PTEN levels in the HF group decreased(t/P=13.809/<0.001),while the levels of CD34 and NT-proBNP increased(t/P=10.462/<0.001,24.509/<0.001).The levels of serum PTEN,CD34,and NT-proBNP gradually decrease with the increase of NYHA grading(F/P=57.753/<0.001),while the levels of CD34 and NT-proBNP gradually increase(F/P=27.626/<0.001,111.566/<0.001).There was no significant difference in gender,age,BMI,hypertension,diabetes,and LVEDD between the patients with good prognosis and those with poor prognosis(P>0.05).The LVEF and PTEN levels in the patients with good prognosis were higher than those in the patients with poor prognosis(t/P=29.827/<0.001,7.566/<0.001),and the CD34 and NT-proBNP levels were lower than those in the patients with poor progno

关 键 词：心力衰竭 同源性磷酸酯酶—张力蛋白 白细胞分化抗原34 氨基末端脑钠尿肽 预后 老年人 

分 类 号：R541.6[医药卫生—心血管疾病]