血清UA、NRG-1与急性心力衰竭患者心衰易损期全因死亡的关系研究  

Relationship between Serum UA and NRG- 1 and All- cause Death in the Vulnerable Phase in Patients with Acute Heart Failure

作　　者：王亚林 丁田田 李姣 王瑞媛 万博雅 刘海超 WANG Yalin;DING Tiantian;LI Jiao;WANG Ruiyuan;WAN Boya;LIU Haichao(Department of Cardiology,Xingtai Central Hospital,Xingtai 054000,Hebei,China;Department of Cardiology,Hebei People′s Hospital,Shijiazhuang 050057,Hebei,China;Department of Cardiology,The First Affiliated Hospital of Hainan Medical College,Haikou 570102,Hainan,China)

机构地区：[1]河北省邢台市中心医院心内科,河北邢台054000 [2]河北省人民医院心内科,河北石家庄050057 [3]海南医学院第一附属医院,海南海口570102

出　　处：《中国分子心脏病学杂志》2024年第4期6259-6263,共5页Molecular Cardiology of China

基　　金：2022年度河北省医学科学研究课题计划(20220895)。

摘　　要：目的 探究血清尿酸(uric acid,UA)、神经调节蛋白-1(neuregulin-1,NRG-1)与急性心力衰竭(acute heart failure,AHF)患者心衰易损期全因死亡的关系。方法 选择2020年9月至2021年9月收治的92例AHF患者(AHF组)及同期接受健康体检的46例急性胸痛患者(对照组),测定并比较两组血清UA、NGR-1水平。依据AHF患者心衰易损期是否发生全因死亡事件分为全因死亡组、非全因死亡组,比较其血清UA、NGR-1水平,应用受试者操作特征(receiver operating characteristic,ROC)曲线分析血清UA、NGR-1及两者联合检测对AHF全因死亡的预测价值,Kaplan-Meier曲线分析不同血清UA、NGR-1水平与AHF患者全因死亡的关系,Cox比例风险模型分析血清UA、NRG-1与AHF患者心衰易损期全因死亡的关系。结果 AHF组血清UA、NGR-1水平[(0.41±0.13)μmol/L、(1.49±0.28)ng/mL]高于对照组[(0.12±0.03)μmol/L、(1.01±0.21)ng/mL,P均<0.05]。全因死亡组血清UA、NGR-1[(0.49±0.11)μmol/L、(1.67±0.32)ng/mL]高于非全因死亡组[(0.40±0.13)μmol/L、(1.46±0.26)ng/mL,P均<0.05]。ROC曲线显示,UA与NGR-1两者联合检测预测AHF患者全因死亡的曲线下面积(area under the curve,AUC)为0.892,特异度为92.06%,高于两者单项检测(Z=2.690、2.244,P均<0.05)。Kaplan-Meier曲线分析显示,高水平UA、NGR-1患者易损期生存率(74.4%、77.3%)明显低于低水平UA、NGR-1患者(94.7%、93.8%)(Log-rank χ^(2)=5.550、4.139,P均<0.05)。Cox比例风险模型分析证实血清UA、NGR-1水平是AHF患者心衰易损期全因死亡的影响因素(P<0.05)。结论 血清UA、NRG-1与AHF患者心衰易损期全因死亡关系密切,两项指标均可用于预测患者全因死亡发生。Objective To investigate the relationship between serum uric acid(UA) and neuregulin-1(NRG-1) and all-cause death in the vulnerable phase in patients with acute heart failure(AHF).Methods A total of 92 patients with AHF admitted to the hospital from September 2020 to September 2021,and 46 patients with acute chest pain(control group) were included in this study.Serum UA and NGR-1 levels were compared between the two groups.According to the presence or absence of all-cause death in the vulnerable phase,patients with AHF were divided into all-cause death group and non-all-cause death group.Serum UA and NGR-1 were compared between the two groups.The predictive value of serum UA,NGR-1,and combination of the two for all-cause death was analyzed using the receiver operating characteristic(ROC) curve.The relationship between serum UA and NGR-1 and all-cause death was analyzed using Kaplan-Meier curve.COX proportional hazard model was used to analyze the relationship between serum UA and NRG-1 and all-cause death in the vulnerable phase in patients with AHF.Results Serum UA and NGR-1 levels in the AHF group [(0.41 ± 0.13) μmol/L and(1.49 ± 0.28) ng/mL] were higher than those in the control group [(0.12 ± 0.03) μmol/L,(1.01 ±0.21) ng/mL](P< 0.05).Serum UA and NGR-1 levels in the all-cause death group [(0.49 ± 0.11) μmol/L and(1.67 ±0.32) ng/mL] were higher than those in the non-all-cause death group [(0.40 ± 0.13) μmol/L and(1.46 ± 0.26) ng/mL](P<0.05).ROC curve analysis found that the area under the curve(AUC) and specificity of UA combined with NGR-1 for predicting allcause death in patients with AHF were higher than those of single prediction(Z= 2.690,2.244,P< 0.05).Kaplan-Meier curve analysis found that the survival rates of patients with high UA level and high NGR-1 level(74.4% and 77.3%) were significantly lower than those with low UA level and low NGR-1 level(94.7% and 93.8%)(Log-rankχ2= 5.550,4.139,P< 0.05).Cox proportional hazard model analysis confirmed that serum UA and NGR-1 levels were influencin

关 键 词：尿酸 神经调节蛋白-1 急性心力衰竭 心衰易损期 全因死亡 

分 类 号：R541.6[医药卫生—心血管疾病]