血清sST2、NT-proBNP、hs-TnT检测在慢性心肾综合征中的应用价值  

The application value of serum sST2,NT-proBNP,hs-TnT detection in chronic cardiorenal syndrome

作　　者：朱迎春 白寿军 姬婷婷 唐波 王亚琨 ZHU Yingchun;BAI Shoujun;JI Tingting;TANG Bo;WANG Yakun(Department of Nephrology,Qingpu Branch,Zhongshan Hospital Affiliated to Fudan University,Shanghai 201700,China)

机构地区：[1]复旦大学附属中山医院青浦分院肾内科,上海201700

出　　处：《检验医学与临床》2024年第24期3616-3620,共5页Laboratory Medicine and Clinic

基　　金：上海市青浦区科技发展基金项目(QKY2021-04);上海市青浦区卫生健康委员会科研课题(QWJ2022-19);上海市青浦区科学技术委员会长三角数字干线青浦区科技发展基金项目(QKY2023-13)。

摘　　要：目的探讨血清可溶性人基质裂解素2(sST2)、N末端B型钠尿肽前体(NT-proBNP)、高敏肌钙蛋白T(hs-TnT)与慢性心肾综合征患者心肾功能的关系及其对慢性心肾综合征的诊断价值。方法选取2021年7月至2022年12月在该院肾内科、心内科住院治疗的慢性心肾综合征患者100例作为观察组,同期入院的无心脏病和肾功能不全的100例其他疾病患者作为对照组;根据美国纽约心脏病协会(NYHA)心功能分级将慢性心肾综合征患者分为心功能Ⅰ级16例,心功能Ⅱ级27例,心功能Ⅲ级39例,心功能Ⅳ级18例;根据慢性肾脏病(CKD)分期分为1~2期32例,3~4期52例,5期16例。比较观察组与对照组血清sST2、NT-proBNP、hs-TnT水平;比较不同NYHA心功能分级及CKD分期慢性心肾综合征患者sST2、NT-proBNP、hs-TnT水平;分析慢性心肾综合征患者sST2、NT-proBNP、hs-TnT水平与NYHA心功能分级、CKD分期的相关性;采用受试者工作特征(ROC)曲线评估血清sST2、NT-proBNP、hs-TnT单独及联合检测对慢性心肾综合征的诊断效能。结果观察组血清sST2、NT-proBNP、hs-TnT水平高于对照组,差异均有统计学意义(P<0.05)。血清sST2、NT-proBNP、hs-TnT水平均为NYHA心功能分级Ⅰ级<Ⅱ级<Ⅲ级<Ⅳ级,且任意两个分级间比较,差异均有统计学意义(P<0.05)。慢性心肾综合征患者血清sST2、NT-proBNP、hs-TnT水平与NYHA心功能分级呈正相关(r=0.724、0.949、0.857,P<0.05)。血清sST2、NT-proBNP、hs-TnT水平均为CKD分期1~2期<3~4期<5期,且任意两个分期间比较,差异均有统计学意义(P<0.05)。慢性心肾综合征患者血清sST2、NT-proBNP、hs-TnT水平与CKD分期呈正相关(r=0.414、0.535、0.480,P<0.05)。血清sST2、NT-proBNP、hs-TnT及3项指标联合检测诊断慢性心肾综合征的曲线下面积(AUC)分别为0.835(95%CI:0.777~0.892)、0.841(95%CI:0.788~0.895)、0.842(95%CI:0.789~0.896)、0.977(95%CI:0.960~0.993),血清sST2、NT-proBNP、hs-TnT 3项联合检测诊断慢性�Objective To explore the relationship between serum soluble human matrix lyrin 2(sST2),N-terminal pro B-type natriuretic peptide(NT-proBNP),high-sensitivity troponin T(hs-TnT)and cardiorenal function in patients with chronic cardiorenal syndrome and their diagnostic value for chronic cardiorenal syndrome.Methods A total of 100 patients with chronic cardiorenal syndrome were selected as the observation group in the Department of Nephrology and Cardiology in Qingpu Branch,Zhongshan Hospital Affiliated to Fudan University from July 2021 to December 2022,and 100 patients with other diseases without heart disease and renal insufficiency admitted in the same period were selected as the control group.According to the New York Heart Association(NYHA)cardiac function classification,the patients with chronic cardiorenal syndrome were divided as 16 cases of cardiac functionⅠ,27 cases of cardiac functionⅡ,39 cases of cardiac functionⅢ,and 18 cases of cardiac functionⅣ.According to the stage of chronic kidney disease(CKD),they were divided as stage 1-2(32 cases),stage 3-4(52 cases)and stage 5(16 cases).The serum levels of sST2,NT-proBNP and hs-TnT were compared between the observation group and the control group.The levels of sST2,NT-proBNP and hs-TnT in patients with chronic cardiorenal syndrome were compared among patients with different NYHA cardiac function grades and CKD stages.The correlation of sST2,NT-proBNP,hs-TnT levels with NYHA classification and CKD staging was analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of serum sST2,NT-proBNP and hs-TnT alone and in combination for chronic cardiorenal syndrome.Results The levels of serum sST2,NT-proBNP and hs-TnT in the observation group were significantly higher than those in the control group(P<0.05).The levels of serum sST2,NT-proBNP and hs-TnT increased in turn in NYHA cardiac function classification gradeⅠ,gradeⅡ,gradeⅢ,gradeⅣpatients,the differences between any two grades were statistically significant(

关 键 词：慢性心肾综合征 可溶性人基质裂解素2 N末端B型钠尿肽前体 高敏肌钙蛋白T 诊断 

分 类 号：R446.9[医药卫生—诊断学] R692.5[医药卫生—临床医学]