血清CD38水平与心力衰竭患者生活质量评估的临床研究  

Clinical Study of Serum CD38 Levels and Quality of Life Assessment in Patients with Heart Failure

作　　者：端家豪 王茹婷 冯钦文 黄凯 应杭峰 杨春[3] 朱滨[2] 杨玲[1] DUAN Jiahao;WANG Ruting;FENG Qinwen(Department of Cardiology,The Third Affiliated Hospital of Soochow University,Jiangsu 213003,China)

机构地区：[1]苏州大学附属第三医院心血管内科,213003 [2]苏州大学附属第三医院重症医学科,213003 [3]南京医科大学附属第一医院麻醉及围术期医学科,210029

出　　处：《医学研究杂志》2024年第3期72-77,共6页Journal of Medical Research

基　　金：国家自然科学基金资助项目(82070405)。

摘　　要：目的 研究心力衰竭患者血清白细胞分化抗原38(CD38)水平的表达情况,并据此构建用于心力衰竭患者活动耐量与生活质量的预测模型。方法 应用酶联免疫吸附试验(enzyme-linked immunosorbent assay, ELISA)检测51例心力衰竭患者(心力衰竭组)及8例健康受试者(对照组)的血清CD38水平。根据入院后堪萨斯城心肌病调查问卷(Kansas City Cardiomyopathy Questionnaire-12,KCCQ-12)评分的中位数进一步将心力衰竭患者分为低KCCQ-12评分组及高KCCQ-12评分组。通过套索回归(LASSO)筛选预测变量,建立心力衰竭患者活动耐量与生活质量的预测模型。采用受试者工作特征曲线、校准曲线及决策曲线评价模型,自举重采样(bootstrap-resampling)进行模型的内部验证。结果 与对照组比较,心力衰竭组的血清CD38水平明显升高(0.09±0.08ng/ml vs 0.30±0.37ng/ml,P=0.025)。心力衰竭组患者血清CD38水平与白细胞数量的相关性系数为0.253(P=0.073)。高KCCQ-12评分组的血清CD38水平较低KCCQ-12评分组明显升高(0.42±0.49分vs 0.20±0.17分,P=0.035)。通过LASSO筛选预测变量,最终纳入血清CD38水平等8个变量建立用于心力衰竭患者的活动耐量与生活质量的预测模型,该模型的曲线下面积为0.939,具有良好的区分度及校准度。经Bootstrap内部验证(取样次数500次),一致性指数(C-index)为0.918。结论 心力衰竭患者的血清CD38水平显著升高。基于血清CD38水平构建的预测模型有利于协助评估心力衰竭患者的活动耐量与生活质量。Objective To investigate the expression of serum CD38 levels in patients with heart failure(HF),and to construct a prediction model for activity tolerance and quality of health in patients with HF.Methods The serum CD38 levels of 51 HF patients(HF group)and 8 healthy subjects(control group)were detected by enzyme-linked immunosorbent assay(ELISA).HF patients were further divided into low Kansas City Cardiomyopathy Questionnaire-12(KCCQ-12)group and high KCCQ-12 group based on the median of KCCQ-12 scores after admission.The predictive variables were screened by the least absolute shrinkage and selection operator(LASSO)to establish a prediction model for activity tolerance and quality of life in patients with HF.The model was evaluated by receiver operating characteristics curve,calibration curve and decision curve analysis,and internal validation of the model was performed by Bootstrap-resampling.Results Compared with the control group,the serum CD38 levels in the HF group was significantly increased(0.09±0.08ng/ml vs 0.30±0.37ng/ml,P=0.025).The correlation coefficient between serum CD38 levels and white blood counts was 0.253(P=0.073)in HF group.The serum CD38 levels in the high KCCQ-12 group were significantly higher than that in the low KCCQ-12group(0.42±0.49 score vs 0.20±0.17 score,P=0.035).The predictor variables were screened by LASSO,and eight variables including serum CD38 level were finally included to establish a predictive model for activity tolerance and quality of life in patients with HF.The area under the curve of the model was 0.939,and the model had good discrimination and calibration.The consistency index(C-index)was 0.918 as verified internally by Bootstrap(500 resamplings).Conclusion The serum CD38 levels of patients with HF were significantly increased.The prediction model based on serum CD38 levels is helpful in assessing the activity tolerance and quality of life in patients with HF.

关 键 词：心力衰竭 CD38 生活质量 套索回归 预测模型 

分 类 号：R54[医药卫生—心血管疾病]