血清ATX、TN-C与老年扩张型心肌病合并心力衰竭患者心室重构指标的相关性及对预后的影响  

Correlation of serum ATX,TN-C and ventricular remodeling indexes in elderly patients with dilated cardiomyopathy with heart failure and their effects on prognosis

作　　者：高妍芬 葛青 邹鹏 陆晓丹 刘敏 GAO Yanfen;GE Qing;ZOU Peng;LU Xiaodan;LIU Min(Cadre Ward,904th Hospital of the Joint Logistic Support Force,Wuxi,Jiangsu 214044,China;Department of Cardiology,Yongzhou Fourth People′s Hospital,Yongzhou,Hunan 425006,China)

机构地区：[1]联勤保障部队第九〇四医院干部病房,江苏无锡214044 [2]永州市第四人民医院心内科,湖南永州425006

出　　处：《国际检验医学杂志》2024年第15期1816-1821,1827,共7页International Journal of Laboratory Medicine

基　　金：江苏省卫生健康委医学科研项目(2020037)。

摘　　要：目的探讨血清自分泌运动因子(ATX)、肌腱蛋白-C(TN-C)与老年扩张型心肌病(DCM)合并心力衰竭(HF)患者心室重构指标的相关性及对预后的影响。方法选取2020年1月至2022年1月联勤保障部队第九〇四医院收治的153例老年DCM合并HF患者作为DCM合并HF组,另选取同期该院100例老年单纯DCM患者作为DCM组及100例体检的健康老年人作为对照组。采用酶联免疫吸附试验法检测血清ATX、TN-C水平,超声心动图检测心室重构指标[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左室射血分数(LVEF)]。通过Pearson相关性分析老年DCM合并HF患者血清ATX、TN-C水平与心室重构指标的相关性。对老年DCM合并HF患者随访1年,根据预后情况分为预后不良组和预后良好组。老年DCM合并HF患者预后不良的影响因素通过单因素及多因素Logistic回归分析,血清ATX、TN-C水平对老年DCM合并HF患者预后不良的预测价值通过受试者工作特征(ROC)曲线分析。结果DCM合并HF组血清ATX、TN-C水平高于DCM组、对照组,差异有统计学意义(P<0.05);DCM组血清ATX、TN-C水平高于对照组,差异有统计学意义(P<0.05)。DCM合并HF组LVEDD、LVESD高于DCM组、对照组,LVEF低于DCM组、对照组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,老年DCM合并HF患者血清ATX、TN-C水平与LVEDD、LVESD呈正相关,与LVEF呈负相关(P<0.05)。单因素分析显示,HF病程、NYHA心功能分级、NT-proBNP、ATX、TN-C为老年DCM合并HF患者预后不良的影响因素(P<0.05)。多因素Logistic回归分析结果显示,老年DCM合并HF患者预后不良的独立危险因素为NYHA心功能分级≥Ⅲ级和NT-proBNP、ATX、TN-C升高(P<0.05)。ROC曲线分析显示,血清ATX、TN-C水平单独和联合对老年DCM合并HF患者预后不良的曲线下面积及其95%CI分别为0.743(0.576~0.911)、0.721(0.551~0.911)、0.808(0.690~0.912)。结论老年DCM合并HF患者的血清ATX、TN-C水平�Objective To investigate the correlation analysis of serum autotaxin(ATX),tenascin-C(TN-C)and ventricular remodeling indexes in elderly patients with dilated cardiomyopathy(DCM)with heart failure(HF)and their effects on prognosis.Methods 153 elderly patients with DCM with HF who were admitted to the 904th Hospital of the Joint Logistic Support Force from January 2020 to January 2022 were selected as DCM with HF group,and 100 elderly patients with simple DCM in the same hospital during the same period were selected as DCM group and 100 healthy elderly individuals who underwent physical examination were selectedas control group.Serum ATX and TN-C levels were detected by enzyme-linked immunosorbent assay,and ventricular remodeling indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and left ventricular ejection fraction(LVEF)]were detected by echocardiography.The correlation between serum ATX,TN-C levels and ventricular remodeling indexes in elderly patients with DCM with HF were analyzed by Pearson correlation analysis.Elderly patients with DCM with HF were followed up for 1 year,patients were divided into poor prognosis group and good prognosis group according to the prognosis.The influencing factors of poor prognosis in elderly patients with DCM with HF were analyzed by univariate and multivariate logistic regression analysis,the predictive value of serum ATX and TN-C levels for poor prognosis in elderly patients with DCM with HF was analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of ATX and TN-C in DCM combined HF group were higher than those in DCM group and control group,and the difference was statistically significant(P<0.05).Serum ATX and TN-C levels in DCM group were higher than those in control group,and the difference was statistically significant(P<0.05).LVEDD and LVESD in DCM with HF group were higher than those in DCM group and control group,and LVEF was lower than those in DCM group and control group,the difference was s

关 键 词：老年 扩张型心肌病 心力衰竭 自分泌运动因子 肌腱蛋白-C 

分 类 号：R542.2[医药卫生—心血管疾病]