血清丝氨酸蛋白酶Corin在慢性肾衰竭合并心力衰竭患者中的诊断价值  

Diagnostic value of serum serine protease Corin in patients with chronic renal failure complicated with heart failure

作　　者：周鹏飞 刘诗语 方汶 陈瑞华[2] 周子涵 侯小美 燕宇彤 胡亚会 Zhou Pengfei;Liu Shiyu;Fang Wen;Chen Ruihua;Zhou Zihan;Hou Xiaomei;Yan Yutong;Hu Yahui(Department of Reproductive medicine,Third Affiliated Hospital of Zhengzhou Medical University,Zhengzhou 450052,China;The Fifth Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450003,China;Medical Clinical Laboratory,the Fifth Clinical Medical College of Henan University of Chinese Medicine/Zheng Zhou People′s Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学第三附属医院生殖医学科,郑州450052 [2]河南中医药大学第五临床医学院,郑州450003 [3]河南中医药大学第五临床医学院/郑州人民医院医学检验科,郑州450003

出　　处：《中华检验医学杂志》2024年第6期610-618,共9页Chinese Journal of Laboratory Medicine

基　　金：河南省自然科学基金青年项目(222300420220);河南省医学科技攻关计划联合共建项目(LHGJ20210702)。

摘　　要：目的探讨血清丝氨酸蛋白酶(Corin)在慢性肾衰竭(CRF)合并心力衰竭患者中的诊断价值。方法回顾性分析2023年1月1日至12月31日于郑州人民医院住院的CRF合并心力衰竭患者120例,(64.05±13.89)岁,男77例(64.17%),单纯CRF患者87例,60.59±8.78岁,男54例(62.07%)作为对照组。收集患者临床基本信息、实验室检测指标和超声心动图参数,并用酶联免疫吸附实验检测血清Corin的浓度。根据美国纽约心脏病学会心功能分级将试验组分为Ⅱ级(31例)、Ⅲ级(47例)、Ⅳ级(42例)。比较实验组和对照组患者以及不同心功能分级组间血清Corin水平。采用Spearman相关性分析血清Corin与脑钠肽(BNP)、D-二聚体的相关性。ROC曲线分析血清Corin对CRF合并心力衰竭以及不同心功能分级的预测价值;采用二元Logistic回归构建多指标联合预测模型,得出联合预测概率,绘制ROC曲线,比较血清Corin、BNP对CRF合并心力衰竭的诊断价值以及血清Corin联合D-二聚体、BNP对CRF合并心力衰竭的诊断价值。结果CRF合并心力衰竭组血清Corin[2568.97±477.70 pg/ml比1727.81±480.60 pg/ml,t=12.47,P<0.001]、BNP[700.00(256.00,2089.75)pg/ml比88.00(43.00,230.00)pg/ml,Z=-9.00,P<0.001]、D-二聚体[1150.00(643.00,1874.75)μg/L比556.00(301.00,865.00)μg/L,Z=-6.57,P<0.001]高于单纯CRF组,差异有统计学意义。在CRF合并心力衰竭患者不同心功能分级三组间,血清Corin[2231.74±311.39 pg/ml比2562.09±365.30 pg/ml比2825.57±536.83 pg/ml,F=74.33,P<0.001]、BNP[234.00(168.00,612.00)pg/ml比514.00(260.00,1455.00)pg/ml比2200.00(640.50,4682.75)pg/ml,H=29.42,P<0.001]、D-二聚体[753.00(514.00,1280.00)μg/L比1187.00(590.00,1840.00)μg/L比1603.00(810.00,3313.25)μg/L,H=14.98,P<0.001]随心功能分级递增而升高,且差异有统计学意义。根据Spearman相关分析结果,血清Corin与BNP(r=0.409)、D-二聚体(r=0.299)呈正相关(P<0.001)。经ROC曲线分析,血清Corin诊断CRF合并心力衰竭及心功能Ⅱ级、�Objective To investigate the diagnostic value of serum serine protease(Corin)in chronic renal failure(CRF)complicated with heart failure.Methods A retrospective analysis was conducted on 120 patients,(64.05±13.89)years old,77 male(64.17%),with chronic renal failure combined with heart failure admitted to Zhengzhou People′s Hospital from January 1,2023,to December 31,2023.The control group consisted of 87 patients,(60.59±8.78)years old,54 male(62.07%),with simple chronic renal failure.Clinical information,laboratory test indicators and echocardiographic parameters were collected.Serum Corin concentration was measured using enzyme-linked immunosorbent assay(ELISA).The experimental group was divided into gradeⅡ(31 cases),gradeⅢ(47 cases)and gradeⅣ(42 cases)according to the New York College of Cardiology heart function classification system.Serum Corin levels were compared between the experimental group and the control group and among different cardiac function grades.Spearman correlation analysis was performed to evaluate the relationship between serum Corin and brain natriuretic peptide(BNP),D-dimer.ROC analysis was conducted to assess the predictive value of serum Corin in CRF complicated with heart failure and cardiac function classification;Binary Logistic regression was used to construct a multi-index joint prediction model,the joint prediction probability was obtained,and ROC curve was drawn to compare the diagnostic value of serum Corin and BNP in CRF combined with heart failure and the diagnostic value of serum Corin combined with D-dimer and BNP in CRF combined with heart failure.Results The serum Corin level[2568.97±477.70 pg/ml vs.1727.81±480.60 pg/ml,t=12.47,P<0.001],BNP[700.00(256.00,2089.75)pg/ml compared with 88.00(43.00,230.00)pg/ml,Z=-9.00,P<0.001],D-dimer[1150.00(643.00,1874.75)μg/L compared with 556.00(301.00,865.00)μg/L,Z=-6.57,P<0.001]in chronic renal failure complicated with heart failure group was higher than that in simple CRF group,and the difference was statistically significa

关 键 词：肾功能衰竭 慢性 心力衰竭 丝氨酸蛋白酶 心功能分级 

分 类 号：R692.5[医药卫生—泌尿科学] R541.6[医药卫生—外科学]