老年慢性心力衰竭患者血清Fibulin-3、TEM1、PACAP-38水平与心功能分级及预后不良的关系  

Correlation between serum Fibulin-3,TEM1,PACAP-38 levels and cardiac functiongrading and poor prognosis in elderly patients with chronic heart failure

作　　者：张霞 邢爱君[1] 张晖[1] 曲安然 ZHANG Xia;XING Aijun;ZHANG Hui;QU Anran(The Third Department of Cardiovascular Medicine,Kailuan General Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]开滦总医院心血管内科三病区,河北唐山063000

出　　处：《检验医学与临床》2025年第1期112-118,共7页Laboratory Medicine and Clinic

基　　金：河北省2021年度医学科学研究课题(20210929)。

摘　　要：目的分析老年慢性心力衰竭(CHF)患者血清纤维蛋白-3(Fibulin-3)、抗人肿瘤内皮标志物1(TEM1)、垂体腺苷酸环化酶激活多肽-38(PACAP-38)水平与心功能分级及预后不良的关系。方法选取2020年7月至2023年7月该院收治的132例老年CHF患者作为老年CHF组,另选取同期在该院进行体检的132例健康者作为对照组。按照美国纽约心脏病协会(NYHA)心功能分级标准将老年CHF患者分为Ⅱ级组(42例)、Ⅲ级组(51例)、Ⅳ级组(39例)。根据患者出院后是否发生MACE将老年CHF患者分为MACE组和未MACE组。采用酶联免疫吸附试验(ELISA)检测所有受试者血清Fibulin-3、TEM1、PACAP-38水平。采用Spearman相关分析老年CHF患者血清Fibulin-3、TEM1、PACAP-38水平与心功能分级的相关性。采用多因素Logistic回归分析老年CHF患者发生MACE的影响因素。绘制受试者工作特征(ROC)曲线分析血清Fibulin-3、TEM1、PACAP-38对老年CHF患者发生MACE的预测价值。结果老年CHF组血清TEM1水平高于对照组,血清Fibulin-3、PACAP-38水平均低于对照组,差异均有统计学意义(P<0.05)。不同心功能分级老年CHF患者血清TEM1水平比较,Ⅱ级组<Ⅲ级组<Ⅳ级组,且任意两组间比较,差异均有统计学意义(P<0.05)。不同心功能分级老年CHF患者血清Fibulin-3、PACAP-38水平比较,Ⅱ级组>Ⅲ级组>Ⅳ级组,且任意两组间比较,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,老年CHF患者心功能分级与血清TEM1水平呈正相关(r_(s)=0.488,P<0.05),与Fibulin-3、PACAP-38水平呈负相关(r_(s)=-0.463、-0.432,P<0.05)。MACE组有38例患者,未MACE组有94例患者。MACE组血清Fibulin-3、PACAP-38水平均低于未MACE组,血清TEM1水平及心功能分级为Ⅳ级患者比例高于未MACE组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血清Fibulin-3、PACAP-38水平升高是老年CHF患者发生MACE的保护因素(P<0.05),血清TEM1水平升高及心�Objective To analyze the correlation between serum Fibulin-3,anti-human tumor endothelial marker 1(TEM1),pituitary adenylate cyclase activating polypeptide-38(PACAP-38)levels and cardiac function grading and poor prognosis in elderly patients with chronic heart failure(CHF).Methods A total of 132 elderly CHF patients admitted to this hospital from July 2020 to July 2023 were selected as the elderly CHF group,and 132 healthy subjects who underwent physical examination in this hospital during the same period were selected as the control group.According to the New York Heart Association(NYHA)cardiac function grading criteria,the elderly patients with CHF were divided into gradeⅡgroup(42 cases),gradeⅢgroup(51 cases)and gradeⅣgroup(39 cases).According to the occurrence of MACE after discharge,elderly CHF patients were divided into MACE group and non-MACE group.Enzyme linked immunosorbent assay(ELISA)was used to detect the expression levels of serum Fibulin-3,TEM1 and PACAP-38.Spearman correlation analysis was used to analyze the correlation between serum Fibulin-3,TEM1,PACAP-38 levels and cardiac function classification in elderly patients with CHF.Multivariate Logistic regression was used to analyze the influencing factors of MACE in elderly patients with CHF.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Fibulin-3,TEM1 and PACAP-38 for MACE in elderly CHF patients.Results Serum TEM1 level of elderly CHF group was higher than that of control group,and serum Fibulin-3 and PACAP-38 levels of elderly CHF group were lower than those of control group,and the differences were statistically significant(P<0.05).The serum TEM1 level of elderly CHF patients with different cardiac function grades was compared in gradeⅡgroup<gradeⅢgroup<gradeⅣgroup,and the difference between any two groups was statistically significant(P<0.05).Comparison of serum Fibulin-3 and PACAP-38 levels in elderly CHF patients with different cardiac function grades,gradeⅡgroup>gradeⅢgroup>

关 键 词：慢性心力衰竭 纤维蛋白-3 抗人肿瘤内皮标志物1 垂体腺苷酸环化酶激活多肽-38 心功能分级 预后 

分 类 号：R541.6[医药卫生—心血管疾病] R541.8[医药卫生—内科学]