血清ET-1、NT-proBNP、HIF-1α水平与急性左心衰竭患者预后的相关性  

Correlation between serum ET-1,NT-proBNP,HIF-1αlevels and prognosis of patients with acute heart failure

作　　者：吴倩 杨娟 孙斌 WU Qian;YANG Juan;SUN Bin(Department of Clinical Laboratory,Affiliated Hospital of West Anhui Health Vocational College,Lu an 237008,Anhui,China)

机构地区：[1]皖西卫生职业学院附属医院检验科,安徽六安237008

出　　处：《川北医学院学报》2024年第8期1064-1067,共4页Journal of North Sichuan Medical College

基　　金：安徽省卫生健康科研项目(AHWJ2022c056)。

摘　　要：目的:探讨血清内皮素1(ET-1)、N端-B型钠尿肽前体(NT-proBNP)、缺氧诱导因子1α(HIF-1α)水平与急性左心衰竭(AHF)患者预后的相关性。方法:纳入AHF患者作为研究对象(AHF组,n=108);另纳入同期健康体检者为对照(对照组,n=100)。受试者均进行血清ET-1、NT-proBNP、HIF-1α水平检测。根据随访1年患者是否发生心血管不良事件,将患者分为预后不良组(n=50)与预后良好组(n=58)。使用Logistic回归模型分析AHF患者预后的相关因素,并使用受试者工作特征(ROC)曲线评价各指标对预后的预测能力。结果:AHF组血清ET-1、NT-proBNP、HIF-1α水平均高于对照组(P<0.05),且随着心功能分级提高,患者血清ET-1、NT-proBNP、HIF-1α水平逐渐增高(P<0.05)。与预后良好组比较,预后不良组血清ET-1、NT-proBNP、HIF-1α水平均更高(P<0.05)。Logistic回归分析显示,血清NT-proBNP(OR=1.273)、ET-1(OR=1.365)、HIF-1α(OR=1.670)是AHF患者预后不良的危险因素(P<0.05)。ROC曲线分析显示,血清ET-1、NT-proBNP、HIF-1α水平对于患者预后不良均有一定预测能力(AUC=0.751、0.730、0.744),三者联合的AUC为0.862,高于单一指标的诊断效能(P<0.05)。结论:血清ET-1、NT-proBNP、HIF-1α水平与AHF患者心功能分级及预后均存在相关性,三者均可作为预后参考指标,联合应用可提高对预后不良的预测能力。Objective:To investigate the correlation between serum endothelin-1(ET-1),B-type natriuretic peptide precursor(NT-proBNP),hypoxia-inducible factor-1α(HIF-1α)levels and prognosis of patients with acute heart failure(AHF).Methods:108 patients with AHF were selected as the AHF group,and 100 healthy subjects were selected as the control group.The levels of serum ET-1,NT-proBNP and HIF-1αwere detected in all subjects.The patients were divided into poor prognosis group(n=50)and good prognosis group(n=58)according to the occurrence of cardiovascular adverse events during the 1-year follow-up.Logistic regression model was used to analyze the prognostic factors of AHF patients,and the receiver operating characteristic(ROC)curve was used to evaluate the prognostic predictive ability of each index.Results:The levels of serum ET-1,NT-proBNP and HIF-1αin AHF group were higher than those in control group(P<0.05),and the levels of serum ET-1,NT-proBNP and HIF-1αgradually increased with the increase of cardiac function classification(P<0.05).Compared with the good prognosis group,the levels of serum,ET-1,NT-proBNP and HIF-1αin the poor prognosis group were higher(P<0.05).Logistic regression analysis showed that serum NT-proBNP(OR=1.273),ET-1(OR=1.365),HIF-1α(OR=1.670)were risk factors for poor prognosis in patients with AHF(P<0.05).ROC curve analysis showed that serum ET-1,NT-proBNP and HIF-1αlevels had certain predictive ability in predicting poor prognosis of patients,and their AUC were 0.751,0.730 and 0.744 respectively.The AUC of the combination of the three reached 0.862,which was higher than that of each single index(P<0.05).Conclusion:Serum ET-1,NT-proBNP and HIF-1αlevels are associated with cardiac function classification and prognosis in patients with AHF.All three can be used as prognostic reference indicators,and combined application can improve the predictive ability of poor prognosis.

关 键 词：急性左心衰竭 预后 内皮素1 N端B型钠尿肽前体 缺氧诱导因子1Α 

分 类 号：R541.6[医药卫生—心血管疾病]