血清SDF-1、CXCL16及NT-proBNP联合检测在慢性心力衰竭中的诊断价值  

Diagnostic value of Combined Detection of Serum SDF-1,CXCL16 and NT-proBNP on Chronic Heart Failure

作　　者：丁田田 王亚林 李姣 王瑞媛 万博雅 DING Tiantian;WANG Yalin;LI Jiao;WANG Ruiyuan;WANG Boya(Department of Cardiology,Xingtai Central Hospital,Xingtai 054000,Hebei,China;Department of Cardiology,Hebei Provincial People's Hospital,Shijiazhuang 050057,Hebei,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

出　　处：《中国分子心脏病学杂志》2024年第5期6363-6368,共6页Molecular Cardiology of China

基　　金：2022年度河北省医学科学研究课题计划项目(20220895)。

摘　　要：目的分析血清基质细胞衍生因子1(stromal-derived factor-1,SDF-1)、CXC趋化因子配体16(CXC chemokine ligand-16,CXCL16)、N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)在慢性心力衰竭(chronic heart failure,CHF)中的表达及对CHF的诊断价值。方法选择2019年12月至2022年9月收治的212例疑似CHF患者,入院后根据血清SDF-1、CXCL16、NT-proBNP检测及超声心动图检查结果,分为CHF组(130例)和非CHF组(82例)。分析CHF患者血清SDF-1、CXCL16、NT-proBNP表达,及其与心功能、心室重构关系,并分析其对CHF诊断价值。结果CHF组血清SDF-1、CXCL16及NT-proBNP水平高于非CHF组(P均<0.05),且随着心功能分级加重,血清SDF-1、CXCL16及NT-proBNP水平升高(P均<0.05)。CHF组患者左心室射血分数(left ventricular ejection fraction,LVEF)低于非CHF组(P<0.05),左室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)、左心室质量指数(left ventricular mass index,LVMI)高于非CHF组(P均<0.05)。Pearson相关分析结果显示,CHF患者血清SDF-1与LVEF呈负相关(P<0.05),与LVEDD呈正相关(P<0.05);CXCL16、NT-proBNP与LVEF呈负相关(P均<0.05),与LVEDD、LVMI呈正相关(P均<0.05)。多因素logistic回归分析显示,血清SDF-1、CXCL16、NT-proBNP均为CHF发生的危险因素(P均<0.05)。受试者操作特征(receiver operating characteristic,ROC)曲线结果显示,血清SDF-1、CXCL16、NT-proBNP诊断CHF的ROC曲线下面积分别为0.818、0.865、0.912,且三者联合检测诊断效能更大,ROC曲线下面积为0.975,敏感度、特异度分别为0.938、0.732。结论CHF患者血清SDF-1、CXCL16、NT-proBNP水平明显升高,且随着心功能分级加重而升高,与患者心室重构有相关性,三者联合检测对CHF有较高诊断价值。Objective To analyze the expressions of serum stromal cell derived factor 1(SDF-1),CXC chemokine ligand 16(CXCL16)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in chronic heart failure(CHF)and the diagnostic value on CHF.Methods A total of 212 patients with suspected CHF from December 2019 to September 2022 were included in the study.All patients underwent serum SDF-1,CXCL16 and NT-proBNP detection and echocardiography after admission.According to the final clinical diagnosis,the 212 patients were divided into CHF group(n=130)and non-CHF group(n=82).The expressions of serum SDF-1,CXCL16 and NT-proBNP in patients with CHF and the relationship with cardiac function and ventricular remodeling were explored,and the diagnostic value on CHF was analyzed.Results The levels of serum SDF-1,CXCL16 and NT-proBNP in CHF group were significantly higher than those in non-CHF group(all P<0.05),and the levels of serum SDF-1,CXCL16 and NT-proBNP were increased with the exacerbation of cardiac function grade(P<0.05).Compared with non-CHF group,LVEF in CHF group was significantly decreased,while LVEDD and LVMI were significantly increased(all P<0.05).Pearson correlation analysis showed that serum SDF-1 in patients with CHF was negatively correlated with LVEF(P<0.05),and was positively correlated with LVEDD(P<0.05).CXCL16 and NT-proBNP were negatively correlated with LVEF(allP<0.05),and were positively correlated with LVEDD and LVMI(allP<0.05).Multivariate logistic regression analysis showed that serum SDF-1,CXCL16 and NT-proBNP were risk factors of CHF occurrence(allP<0.05).Receiver operating characteristic curve(ROC curve)results showed that the areas under ROC curves of serum SDF-1,CXCL16 and NT-proBNP in the diagnosis of CHF were 0.818,0.865 and 0.912 respectively,and the combined detection of the three indicators had greater diagnostic efficiency,and the area under ROC curve,sensitivity and specificity were 0.975,0.938 and 0.732,respectively.Conclusion Serum levels of SDF-1,CXCL16 and NT-proBNP in patients with CHF are

关 键 词：慢性心力衰竭 基质细胞衍生因子1 趋化因子配体16 N-末端脑钠肽前体 诊断价值 

分 类 号：R541.6[医药卫生—心血管疾病]