血清pro-BNP、Gal-3、Hcy预测老年高血压患者射血分数保留性心力衰竭发病的价值及与心功能分级的关系  

Value of Serum pro-BNP,Gal-3 and Hcy in Predicting Heart Failure with Preserved Ejection Fraction in Elderly Hypertensive Patients and Their Relationship with Cardiac Function Grade

作　　者：应晨[1] 胡家安[2] 徐志红[2] YING Chen;HU Jiaan;XU Zhihong(Department of Vascular Medicine,Shanghai Jiaotong University School of Medicine,Shanghai 201801,China;Department of Geriatrics,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 201801,China)

机构地区：[1]上海交通大学医学院附属瑞金医院心血管内科,上海201800 [2]上海交通大学医学院附属瑞金医院老年病科,上海201800

出　　处：《转化医学杂志》2024年第1期42-47,共6页Translational Medicine Journal

基　　金：上海市卫生和计划生育委员会科研课题计划(201840083)。

摘　　要：目的探讨老年高血压患者血清脑钠肽前体(pro-BNP)、半乳糖凝集素-3(Gal-3)、同型半胱氨酸(Hcy)的相关性,并分析三者联合预测射血分数保留性心力衰竭(HFpEF)发病的价值及与心功能分级的关系。方法选取2018年5月—2021年7月收治的老年高血压208例,根据是否发生HFpEF分为HEpEF组52例与单纯高血压组156例。比较2组血清pro-BNP、Gal-3、Hcy水平,分析三者之间的关系及与心功能分级的相关性,采用危险度分析三者对HEpEF发生风险的影响,采用受试者工作特征(ROC)曲线评价三者联合预测HEpEF发生的价值。结果HEpEF组血清pro-BNP、Gal-3、Hcy水平高于单纯高血压组(P<0.01);Pearson相关性分析显示,单纯高血压组、HEpEF组血清pro-BNP、Gal-3、Hcy之间呈正相关(P<0.01),HEpEF组相关性更高;Spearman相关性分析显示,血清pro-BNP、Hcy、Gal-3与NYHA分级呈正相关(P<0.01);多因素Logistic回归分析显示,血清pro-BNP、Gal-3、Hcy水平均对HFpEF发生风险有独立影响(P<0.01);ROC曲线分析显示,血清pro-BNP、Hcy、Gal-3联合预测HFpEF发生风险的曲线下面积为0.939(95%CI:0.898,0.968),敏感度为0.885,特异度为0.833,优于各指标单独预测。结论老年高血压患者血清pro-BNP、Gal-3、Hcy水平显著相关,三者与心功能分级呈正相关,且异常升高会增加HEpEF发生风险,联合预测HFpEF发病价值较为可靠。Objective To investigate the correlation of serum brain natriuretic peptide precursor(pro-BNP),galactin-3(Gal-3)and homocysteine(Hcy)in elderly patients with hypertension,and to analyze the value of their combination in predicting herat failure with preserved ejection fraction(HFpEF)and its relationship with cardiac function classification.Methods From May 2018 to July 2021,208 elderly patients with hypertension were selected and divided into HEpEF group(n=52)and simple hypertension group(n=156)according to occurrence of HFpEF.Serum pro-BNP,Gal-3 and Hcy levels of the two groups were compared,and the relationship between the three indicators and their correlation with cardiac function classification was analyzed.The influence of the three indicators on the incidence risk of HEpEF was analyzed by hazard analysis,and the value of the three in combination in predicting HEpEF was evaluated by receiver operating characteristic(ROC)curve.Results The serum levels of pro-BNP,Gal-3 and Hcy in HEpEF group were higher than those in simple hypertension group(P<0.01).Pearson correlation analysis showed that serum pro-BNP,Gal-3 and Hcy were positively correlated in simple hypertension group and HEpEF group(P<0.01),and the correlation was higher in HEpEF group.Spearman correlation analysis showed that serum pro-BNP,Hcy and Gal-3 were positively correlated with NYHA classification(P<0.01).Multivariate Logistic regression analysis showed that serum pro-BNP,Gal-3 and Hcy levels had independent effects on the risk of HFpEF(P<0.01).ROC curve analysis showed that the area under the curve(AUC)of serum pro-BNP,Hcy and Gal-3 in combination to predict the risk of HFpEF was 0.939(95%CI:0.898,0.968),the sensitivity was 0.885,and the specificity was 0.8333,which was better than the prediction of each index alone.Conclusion Serum pro-BNP,Gal-3 and Hcy levels in elderly hypertensive patients are significantly correlated,the three indicators are positively correlated with cardiac function classification,and abnormal elevation will increase the

关 键 词：心力衰竭 高血压 老年人 脑钠肽前体 同型半胱氨酸 半乳糖凝集素-3 相关性 预测价值 

分 类 号：R541.6[医药卫生—心血管疾病] R544.1[医药卫生—内科学]