心力衰竭患者外周血BNP、TIMP-4水平及二者交互作用对临床预后的影响  

Effect of Peripheral Blood BNP and TIMP-4 Levels and their Interaction on Clinical Prognosis in Patients with Heart Failure

作　　者：崔继婷 田艳珍 宋凌慧 CUI Jiting;TIAN Yanzhen;SONG Linghui(The First Department of Cardiology,the First Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China)

机构地区：[1]张家口市第一医院心内一科,河北张家口075000

出　　处：《临床误诊误治》2024年第1期53-58,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会医学科学研究项目(20191720)。

摘　　要：目的探究心力衰竭患者外周血脑钠肽(BNP)、金属蛋白酶组织抑制因子-4(TIMP-4)及二者交互作用对临床预后的影响。方法选取2020年10月—2022年10月200例心力衰竭作为观察组,另选取同期体检健康者200例作为对照组。比较2组外周血BNP、TIMP-4水平,分析不同水平BNP、TIMP-4对心力衰竭发病风险的影响,比较不同预后患者临床资料及外周血BNP、TIMP-4水平,分析心力衰竭患者预后影响因素及BNP、TIMP-4交互作用对心力衰竭患者预后的影响,评价BNP、TIMP-4对心力衰竭患者预后的预测价值。结果观察组BNP水平较对照组高,TIMP-4水平较对照组低(P<0.05);外周血BNP、TIMP-4高水平患者心力衰竭发病风险分别是低水平患者的3.348倍、0.409倍;预后不良患者左心室射血分数(LVEF)、TIMP-4较预后良好患者低,BNP较预后良好患者高(P<0.01);LVEF及外周血BNP、TIMP-4为心力衰竭患者预后影响因素(P<0.01);心力衰竭患者外周血BNP、TIMP-4存在相加交互作用,且预后不良风险中有32.44%归因于二者交互作用;外周血BNP、TIMP-4联合预测心力衰竭患者预后不良的ROC曲线下面积(AUC)为0.929,二者联合预测的AUC明显较单独指标高(P<0.05)。结论心力衰竭患者外周血BNP水平升高,TIMP-4水平下降,且二者存在交互作用,共同参与心力衰竭病情发展,与患者预后不良密切相关,检测其水平有助于临床医师预判患者预后。Objective To explore the effects of peripheral blood brain natriuretic peptide(BNP)and tissue inhibitor of metalloproteinase-4(TIMP-4)levels and their interaction on clinical prognosis in patients with heart failure(HF).Methods A total of 200 patients with HF from October 2020 to October 2022 were selected as the observation group,and 200 healthy physical examinees during the same period were selected as the control group.The levels of BNP and TIMP-4 in peripheral blood of the two groups were compared to analyze the impact of different levels of BNP and TIMP-4 on the risk of HF.The clinical data and levels of BNP and TIMP-4 in peripheral blood of patients with different prognosis were compared to analyze the prognostic factors of patients with HF and the effect of interaction of BNP and TIMP-4 on the prognosis of patients with HF.The prognostic value of BNP and TIMP-4 in patients with HF was evaluated.Results BNP level in observation group was higher than that in control group,whereas TIMP-4 level was lower than that in control group(P<0.05).The risk of HF in patients with high levels of BNP and TIMP-4 was 3.348 times and 0.409 times higher than that in patients with low levels,respectively.Left ventricular ejection fraction(LVEF)and TIMP-4 in patients with poor prognosis were lower than those with good prognosis,while BNP was higher than those with good prognosis(P<0.01).LVEF,peripheral blood BNP and TIMP-4 were the prognostic factors of patients with HF(P<0.01).There was additive interaction between BNP and TIMP-4 in the peripheral blood of patients with HF,and 32.44%of the risk of poor prognosis was attributed to their interaction.The area under receiver operating characteristic(ROC)curve(AUC)of peripheral blood combined with BNP and TIMP-4 in predicting poor prognosis of patients with HF was 0.929,and the AUC of the combined prediction was significantly higher than that of the single indicator(P<0.05).Conclusion BNP levels in peripheral blood of patients with HF are increased and TIMP-4 levels are decreased;t

关 键 词：心力衰竭 脑钠肽 金属蛋白酶组织抑制因子-4 主要心血管不良事件 影响因素分析 交互作用 预后 

分 类 号：R541.6[医药卫生—心血管疾病]