肺源性心脏病并发肺动脉高压患者血清β-NGF和TRAIL水平检测在临床诊断及预后评估中的意义  

Significance of Serumβ-NGF and TRAIL Testing in Clinical Diagnosis and Prognosis Assessment in Patients with Pulmonary Heart Disease Complicated with Pulmonary Artery Hypertension

作　　者：唐文慧[1] 应会领 段静 董卓 尤欣怡 TANG Wenhui;YING Huiling;DUAN Jing;DONG Zhuo;YOU Xinyi(Department of Infectious Medicine,Daxing District People’s Hospital of Beijing,Beijing 102600,China;Department of Thoracic Surgery,Daxing District People’s Hospital of Beijing,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院感染内科,北京102600 [2]北京市大兴区人民医院胸外科,北京102600

出　　处：《现代检验医学杂志》2024年第4期131-137,共7页Journal of Modern Laboratory Medicine

基　　金：首都卫生发展科研专项项目(首发2020-3-7122)。

摘　　要：目的探讨肺源性心脏病(pulmonary heart disease,PHD)并发肺动脉高压(pulmonary heart disease,PAH)患者血清β-神经生长因子(β-nerve growth factor,β-NGF)、肿瘤坏死因子相关凋亡诱导配体(tumor necrosis factor-related apoptosis-inducing ligand,TRAIL)表达水平及其在临床诊断及预后评估中的意义。方法采用1∶1病例-对照研究设计选取2019年1月~2022年6月北京市大兴区人民医院86例并发PAH的PHD患者为病例组,86例单纯PHD患者为对照组,进行回顾性分析。将病例组根据肺动脉收缩压(pulmonary arterial systolic pressure,PASP)分为轻度PAH组(n=39)、中度PAH组(n=25)和重度PAH组(n=22),根据出院后一年的结果分为预后良好组(n=75)和预后不良组(n=11)。收集研究对象人口学资料和实验室检查指标,采用酶联免疫吸附(ELISA)法检测血清β-NGF,TRAIL水平。Pearson积矩相关分析β-NGF,TRAIL与PASP的关系,Logistic回归分析PHD患者PAH影响因素,ROC曲线评估β-NGF,TRAIL对PAH的诊断价值,COX比例风险回归分析β-NGF,TRAIL与PHD并发PAH患者预后不良的关系,ROC曲线评估其对预后不良的预测价值。结果与对照组比较,病例组PHD病程长(8.63±1.27年vs 5.49±1.15年),血清β-NGF(26.97±8.25 ng/ml vs 22.14±7.32 ng/ml)和TRAIL(2.83±0.76 ng/ml vs 1.71±0.68 ng/ml)水平升高,差异具有统计学意义(t=17.006,4.064,10.183,均P<0.05)。血清β-NGF,TRAIL对PHD患者PAH有诊断价值,AUC分别为0.842,0.838,二者联合诊断的AUC为0.920,诊断价值高于单一指标(Z=3.416,3.508,均P<0.05)。轻度PAH组、中度PAH组和重度PAH组血清β-NGF(23.26±5.13 ng/ml,27.83±5.57 ng/ml,32.57±6.02 ng/ml),TRAIL(2.24±0.65 ng/ml,2.89±0.71 ng/ml,3.81±0.90 ng/ml)水平依次升高,差异具有统计学意义(F=20.624,31.972,均P<0.05)。病例组血清β-NGF,TRAIL与PASP呈正相关(r=0.673,0.659,均P<0.05)。预后不良组血清β-NGF(36.34±8.05 ng/ml),TRAIL(3.49±1.01 ng/ml)水平高于预后良好组(25.59±7.28 ng/ml,2.73±0.89 ng/ml),差�Objective To explore the significance of serumβ-nerve growth factor(β-NGF)and tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)testing in clinical diagnosis and prognosis assessment in patients with pulmonary heart disease(PHD)complicated with pulmonary artery hypertension(PAH).Methods A 1∶1 case-control study was conducted in Daxing District People’s Hospital of Beijing from January 2019 to June 2022,in which 86 patients with PHD complicated with PAH and 86 patients with isolated PHD were selected as case group and control group.Retrospective analysis was conducted.The case group was divided into mild PAH group(n=39),moderate PAH group(n=25)and severe PAH group(n=22)according to pulmonary artery systolic pressure(PASP).Meanwhile,the case group was divided into good prognosis group(n=75)and poor prognosis group(n=11)based on the outcomes after one year of discharge.Demographic data and laboratory examination indicators of study subjects were collected,and serumβ-NGF and TRAIL levels were measured using enzyme-linked immunosorbent assay(ELISA).Pearson product-moment correlation analysis was used to assess the relationship amongβ-NGF,TRAIL and PASP.Logistic regression analysis was performed to identify factors influencing PAH in patients with PHD.ROC curve was used to evaluate the diagnostic value ofβ-NGF and TRAIL for PAH.Cox proportional hazards regression analysis was carried out to assess the relationship amongβ-NGF,TRAIL and poor prognosis in patients with PHD complicated with PAH,and ROC curve was used to evaluate its predictive value for poor prognosis.Result Compared with control group,the duration of PHD in case group was longer(8.63±1.27 years vs 5.49±1.15 years),and serumβ-NGF level(26.97±8.25 ng/ml vs 22.14±7.32 ng/ml)and TRAIL level(2.83±0.76 ng/ml vs 1.71±0.68 ng/ml)were increased,with significant differences(t=17.006,4.064,10.183,all P<0.05).Serumβ-NGF and TRAIL had certain diagnostic values for PAH in PHD patients,with AUC of 0.842 and 0.838,respectively.And the combin

关 键 词：Β-神经生长因子 肿瘤坏死因子相关凋亡诱导配体 肺源性心脏病 肺动脉高压 

分 类 号：R541.5[医药卫生—心血管疾病] R544.16[医药卫生—内科学] R392.11[医药卫生—临床医学]