CTA联合血清DKK3、Sestrin2诊断缺血性心肌病的临床价值  

The Clinical Value of CTA Combined with Serum DKK3 and Sestrin2 in the Diagnosis of Ischemic Cardiomyopathy

作　　者：张英 徐红维 李剑 宋琴 ZHANG Ying;XU Hong-wei;LI Jian;SONG Qin(Department of radiology,Xi'an Fengcheng Hospital,Xi'an 710016,Shaanxi Province,China;Department of Cardiology,Xi'an Fengcheng Hospital,Xi'an 710016,Shaanxi Province,China)

机构地区：[1]西安凤城医院放射科,陕西西安710016 [2]西安凤城医院心内科,陕西西安710016

出　　处：《中国CT和MRI杂志》2025年第2期127-130,共4页Chinese Journal of CT and MRI

基　　金：陕西省重点研发计划项目(2020ZDLSF01-01)。

摘　　要：目的探究血清Dickkopf相关蛋白3(DKK3)、应激诱导蛋白2(Sestrin2)联合CT血管造影(CTA)检查对缺血性心肌病(ICM)的诊断价值。方法选取2021年5月-2023年10月本院收治的385例疑似ICM患者,经冠脉造影(CAG)检查确诊ICM 340例,作为研究组,其余患者作为对照组(45例)。患者均行CTA检查,ICM根据纽约心脏病学会(NYHA)分为轻度、中度和重度组;酶联免疫吸附法检测DKK3、Sestrin2水平;Pearson法分析血清DKK3、Sestrin2的相关性;ICM的影响因素采用多因素Logistic回归分析;绘制ROC曲线分析血清DKK3、Sestrin2对ICM的诊断价值;四格表分析CTA联合血清DKK3、Sestrin2对ICM的诊断效能。结果CTA检查结果显示,其中89例(25.57%)冠脉单支病变,97例(27.87%)双支病变,162例(46.55%)三支病变。研究组血清DKK3水平显著低于对照组(P<0.05),Sestrin2水平显著高于对照组(P<0.05)。根据Pearson相关性分析得知,血清DKK3、Sestrin2呈负相关(P<0.05)。轻度、中度和重度组血清DKK3水平依次降低(P<0.05),Sestrin2依次升高(P<0.05)。多因素Logistic回归分析得知DKK3为影响ICM的保护因素(P<0.05),Sestrin2为危险因素(P<0.05)。根据ROC曲线得知,血清DKK3诊断ICM的AUC为0.890,血清Sestrin2诊断ICM的AUC为0.840,二者联合诊断ICM的AUC为0.939。CTA诊断ICM准确度为87.53%;DKK3诊断ICM准确度为85.45%;Sestrin2诊断ICM准确度为85.71%;三者联合诊断ICM准确度为93.51%。结论DKK3在ICM患者血清中显著降低,Sestrin2显著升高,DKK3、Sestrin2联合CTA检查可提高ICM的诊断价值。Objective To investigate the diagnostic value of serum Dickkopf related protein 3(DKK3)and Sestrin2 combined with CT angiography(CTA)for ischemic cardiomyopathy(ICM).Methods A total of 385 suspected ICM patients admitted to our hospital from May 2021 to October 2023 were regarded as the study group,with 340 confirmed cases of ICM through coronary angiography(CAG)examination.The remaining patients were selected as the control group(45 cases).All patients underwent CTA examination,and ICM was grouped into mild,moderate,and severe groups according to the New York Heart Association(NYHA);enzyme linked immunosorbent assay was applied to detect the levels of DKK3 and Sestrin2;Pearson method was applied to analyze the correlation between serum DKK3 and Sestrin2;the influencing factors of ICM were analyzed using multiple Logistic regression analysis;ROC curve was plotted to analyze the diagnostic value of serum DKK3 and Sestrin2 for ICM;four grid table was applied to analyze the diagnostic efficacy of CTA combined with serum DKK3 and Sestrin2 for ICM.Results CTA examination results showed that 89 cases(25.57%)had single coronary artery disease,97 cases(27.87%)had double coronary artery disease,and 162 cases(46.55%)had triple coronary artery disease.The serum DKK3 level in the study group was obviously lower than that in the control group(P<0.05),and the Sestrin2 level was obviously higher than that in the control group(P<0.05).According to Pearson correlation analysis,serum DKK3 and Sestrin2 showed a negative correlation(P<0.05).The serum DKK3 level in the mild,moderate,and severe groups decreased sequentially(P<0.05),while Sestrin2 level increased sequentially(P<0.05).Multivariate Logistic regression analysis showed that DKK3 was a protective factor affecting ICM(P<0.05),and Sestrin2 was a risk factor(P<0.05).According to the ROC curve,the AUC for diagnosing ICM in serum DKK3 was 0.890,the AUC of serum Sestrin2 for diagnosing ICM was 0.840,and the AUC of the two combination for diagnosing ICM was 0.939.The accuracy of C

关 键 词：Dickkopf相关蛋白3 应激诱导蛋白2 CT血管造影 缺血性心肌病 诊断 

分 类 号：R543.3[医药卫生—心血管疾病]