血清TIMP-1联合心力衰竭超声指数对糖尿病合并心力衰竭患者长期预后的评估价值  

Evaluation value of serum TIMP-1 combined with ultrasound index of heart failure in the long-term prognosis of diabetic patients with heart failure

作　　者：刘左玲 许锦荣 方凌燕 Liu Zuoling;Xu Jinrong;Fang Lingyan(Department of Cardiovascular Medicine,Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China;不详)

机构地区：[1]广东医科大学附属第二医院心血管内科,湛江524000

出　　处：《中国循证心血管医学杂志》2024年第9期1083-1087,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：广东省湛江市科技计划目(2022A01136)。

摘　　要：目的分析血清金属蛋白酶组织抑制因子-1(TIMP-1)联合心力衰竭超声指数对糖尿病合并心力衰竭患者长期预后评估价值。方法选择2019年5月至2020年5月于广东医科大学附属第二医院住院治疗150例糖尿病合并心力衰竭患者作为研究组,根据3年随访期间有无发生主要心血管事件(MACE)分为无MACE组(n=85)与MACE组(n=65);另选择同期我院健康体检人群96例作为对照组。所有纳入对象入院后采用酶联免疫吸附法检测血清TIMP-1水平,应用超声心动图检查评估心力衰竭超声指数。分析比较各组一般资料及生化指标。通过ROC曲线评估血清TIMP-1联合心力衰竭超声指数对糖尿病合并心力衰竭患者长期预后,采用多因素Cox回归分析影响糖尿病合并心力衰竭患者长期预后的相关因素。结果研究组心力衰竭超声指数高于对照组,血清TIMP-1低于对照组(P<0.05);MACE组患者心力衰竭超声指数高于无MACE组,血清TIMP-1低于无MACE组(P<0.05)。ROC曲线分析显示,血清TIMP-1、心力衰竭超声指数评估糖尿病合并心力衰竭患者长期预后的AUC分别为0.812(95%CI:0.762~0.772)、0.827(95%CI:0.777~0.887),血清TIMP-1联合心力衰竭超声指数评估糖尿病合并心力衰竭患者长期预后的AUC为0.909(95%CI:0.879~0.939)。多因素Cox逐步回归分析显示,NT-proBNP(HR=3.387,95%CI:1.863~6.158)、HbA1c(HR=2.713,95%CI:1.552~4.743)、LVEF(HR=3.904,95%CI:2.037~7.484)、TIMP-1(HR=4.397,95%CI:2.142~9.028)、心力衰竭超声指数(HR=3.550,95%CI:1.867~6.752)均为糖尿病合并心力衰竭患者长期预后的影响因素(P<0.05)。结论糖尿病合并心力衰竭患者血清TIMP-1水平降低,心力衰竭超声指数升高,二者均与糖尿病合并心力衰竭患者长期预后密切相关,二者联合对患者长期预后具有更好的评估价值。Objective To assess the prognostic value of serum tissue inhibitor of metalloproteinase 1(TIMP-1)in conjunction with heart failure ultrasound indices for long-term outcomes in patients with diabetes mellitus complicated with heart failure.Methods From May 2019 to May 2020,150 patients with diabetes mellitus complicated by heart failurewere admitted to our hospital and selected for the study group.These patients werebased on the occurrence of major adverse cardiovascular events(MACE)during a three-year follow-up into a non-MACE group(n=85)and a MACE group(n=65).Additionally,96 individuals from a concurrent health screening cohort served as the control group.Upon admission,serum TIMP-1 level was measured using enzyme-linked immunosorbent assay(ELISA),and echocardiograms were performed to evaluate the ultrasound indices of heart failure.The general and biochemical data of each group were analyzed and compared.The prognostic value of combining serum TIMP-1 levels with heart failure ultrasound indices for predicting long-term outcomes in patients with diabetes mellitus and heart failure was assessed using ROC curves.Multivariate Cox regression was utilized to identify factors influencing long-term prognosis in these patients.Results The ultrasound indices of heart failure were significantly higher in the study group than in the control group,while serum TIMP-1 levels were lower(P<0.05).In the MACE group,the ultrasound indices of heart failure were higher and serum TIMP-1 levels were lower compared to the non-MACE group(P<0.05).ROC curve analysis revealed that the AUC for evaluating long-term prognosis in patients with diabetes mellitus complicated by heart failure were 0.812(95%CI:0.762~0.772)for serum TIMP-1 and 0.827(95%CI:0.777~0.887)for the ultrasound index of heart failure.The combined AUC for serum TIMP-1 and the ultrasound index of heart failure was 0.909(95%CI:0.879~0.939).Multivariate Cox regression analysis indicated thatNT-proBNP(HR=3.387,95%CI:1.863~6.158),HbA1c(HR=2.713,95%CI:1.552~4.743),LVEF(HR=3.904,95

关 键 词：糖尿病 心力衰竭 金属蛋白酶组织抑制因子-1 心力衰竭超声指数 预后 

分 类 号：R587.1[医药卫生—内分泌]