慢性肾功能衰竭合并心力衰竭患者血清ST2和NT⁃proBNP的水平及其临床意义  

Levels of serum ST2 and NT⁃proBNP in patients with chronic renal failure and concomitant heart failure and their clinical significance

作　　者：崔雯萱 赵海歌 王彦[1] 梁淑新[1] CUI Wenxuan;ZHAO Haige;WANG Yan;LIANG Shuxin(Department of Laboratory,Affiliated Hospital of Hebei University,Baoding 071000,Hebei,China)

机构地区：[1]河北大学附属医院检验科,河北省保定市071000

出　　处：《广西医学》2024年第11期1676-1681,共6页Guangxi Medical Journal

基　　金：保定市科技计划自筹经费项目(2341ZF350);河北大学附属医院/临床医学院2022年度院内基金项目(2022QC33)。

摘　　要：目的探讨慢性肾功能衰竭合并心力衰竭患者血清生长刺激表达基因2蛋白(ST2)和氨基末端脑钠肽前体(NT⁃proBNP)的水平及其临床意义。方法选取40例慢性肾功能衰竭合并心力衰竭患者(肾衰合并心衰组)、40例单纯心力衰竭患者(单纯心衰组)和40例健康体检者(对照组)作为研究对象,比较3组研究对象肝功能指标(ALT、AST)水平、血脂指标(甘油三酯、总胆固醇、LDL)水平、肾功能指标(血清尿素氮、血清肌酐)水平、心力衰竭患者的纽约心脏病协会(NYHA)分级,以及血清ST2、NT⁃proBNP水平,分析血清ST2、NT⁃proBNP水平与心功能分级、心室指数[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)]的相关性,绘制受试者工作特征曲线分析血清ST2、NT⁃proBNP水平诊断心力衰竭的效能。结果肾衰合并心衰组的甘油三酯水平高于对照组,血清尿素氮、血清肌酐水平高于单纯心衰组和对照组(P<0.05)。肾衰合并心衰组和单纯心衰组的血清ST2、NT⁃proBNP水平高于对照组(P<0.05);肾衰合并心衰组的血清NT⁃proBNP水平、LVEF高于单纯心衰组(P<0.05)。单纯心衰组中NYHA分级Ⅲ~Ⅳ级患者的血清ST2、NT⁃proBNP水平高于Ⅰ~Ⅱ级患者,肾衰合并心衰组中NYHA分级Ⅲ~Ⅳ级患者的血清ST2水平高于Ⅰ~Ⅱ级患者(P<0.05)。单纯心衰组血清ST2、NT⁃proBNP水平与LVEDD呈正相关、与LVEF呈负相关,肾衰合并心衰组血清ST2水平与LVEDD呈正相关、与LVEF呈负相关(P<0.05),而血清NT⁃proBNP水平与LVEDD、LVEF无相关性(P>0.05)。受试者工作特征曲线分析结果显示,在肾衰合并心衰组和单纯心衰组中,血清ST2和NT⁃proBNP水平诊断心力衰竭的效能良好,且具有较高的特异性和灵敏性,但血清ST2水平在两组中的诊断临界值接近(分别为24.14 ng/mL和27.59 ng/mL),而血清NT⁃proBNP水平在两组中的诊断临界值差异较大(分别为1795.00 pg/mL和495.00 pg/mL)。结论NT⁃proBNP和ST2�Objective To explore the levels of serum growth stimulation expressed gene 2(ST2)and N⁃terminal pro⁃B⁃type natriuretic peptide(NT⁃proBNP)in patients with chronic renal failure and concomitant heart failure and their clinical significance.Methods A total of 40 patients with chronic renal failure and concomitant heart failure(the renal failure and concomitant heart failure group),40 patients with simple heart failure(the simple heart failure group),and 40 healthy check⁃up individuals(the control group)were selected as the research subjects.The levels of liver function indices(ALT,AST),blood lipid indices(triglyceride,total cholesterol,LDL)levels,renal function indices(serum urea nitrogen,serum creatinine)levels,New York Heart Association(NYHA)classification of heart failure patients,and levels of serum ST2 and NT⁃proBNP were compared between research subjects of the three groups.The correlation of serum ST2 and NT⁃proBNP levels with cardiac function classification and ventricle mass index(left ventricular end diastolic dimension[LVEDD],left ventricular ejection fraction[LVEF])was analyzed.The efficiency of serum ST2 and NT⁃proBNP levels for diagnosing heart failure was analyzed by drawing the receiver operating characteristic curve.Results The renal failure and concomitant heart failure group exhibited a higher level of triglyceride as compared with the control group,and higher levels of serum urea nitrogen and creatinine as compared with the simple heart failure group and the control group(P<0.05).The renal failure group and concomitant heart failure group and the simple heart failure group interpreted higher serum ST2 and NT⁃proBNP levels as compared with the control group(P<0.05),and the renal failure and concomitant heart failure group yielded higher serum NT⁃proBNP level and LVEF as compared with the simple heart failure group(P<0.05).Patients with NYHA classification inⅢ-Ⅳof the simple heart failure group obtained higher levels of serum ST2 and NT⁃proBNP as compared with patients in�

关 键 词：慢性肾功能衰竭 心力衰竭 生长刺激表达基因2蛋白 氨基末端脑钠肽前体 诊断价值 

分 类 号：R692.5[医药卫生—泌尿科学]