外周血1-磷酸鞘氨醇水平联合6分钟步行试验对慢性心力衰竭患者预后的预测价值  

ROC curve analysis of sphingosine 1-phosphate in peripheral blood combined with 6-minute walk test for the prognosis of patients with chronic heart failure

作　　者：陈文韬[1] 徐广[1] 杜坤[1] 冯秀元[1] 柯碧 湛疆 CHEN Wentao;XU Guang;DU Kun;FENG Xiuyuan;KE Bi;ZHAN Jiang(Department of Cardiology,Ezhou Central Hospital,Ezhou 436000,Hubei,China)

机构地区：[1]鄂州市中心医院心内科,湖北鄂州436000

出　　处：《西部医学》2025年第3期413-418,共6页Medical Journal of West China

基　　金：鄂州市科技局计划项目(EZ01-007-20230031)。

摘　　要：目的探讨1-磷酸鞘胺醇(S1P)与6分钟步行试验距离(6MWD)对慢性心力衰竭(CHF)患者预后的临床预测价值。方法选取2022年1月—12月我院收治的165例CHF患者为CHF组,并选取同期本院165名体检健康者为对照组。检测所有受试者外周血S1P、完成6MWD、左心室射血分数(LVEF)。Person法分析CHF患者外周血S1P表达、6MWD与LVEF的相关性。比较不同预后的两组CHF患者(预后良好组121例,预后不良组44例)临床资料、LVEF、6MWD及外周血S1P。对CHF患者预后的影响因素进行Logistics分析,采用受试者工作特征曲线(ROC)评价外周血S1P、6MWD对CHF患者预后的预测价值。结果CHF组患者外周血S1P表达、6MWD、LVEF明显低于对照组(P<0.05)。CHF患者外周血S1P表达、6MWD均与LVEF呈正相关(P<0.05)。CHF预后良好组患者冠心病比例明显低于预后不良组,S1P、6MWD、LVEF显著高于预后不良组(P<0.05)。Logistics回归分析显示,S1P、6MWD为CHF患者预后的预测因素(P<0.05)。S1P、6MWD预测CHF预后的曲线下面积(AUC)分别为0.897、0.793,截断值分别为0.459、0.634,此时对应灵敏度分别为68.6%、79.3%,特异度分别为52.7%、46.9%。两者联合预测CHF预后的AUC为0.941,其灵敏度、特异度分别为85.1%、71.4%。结论S1P联合6MWD能很好预测CHF患者的预后。Objective To detect the expression of sphingosine 1-phosphate(S1P)in peripheral blood of patients with chronic heart failure(CHF),and explore the clinical predictive value of S1P and 6 MWD for the prognosis of CHF patients combined with 6-minute walk test distance(6MWD).Methods 165 patients with CHF from January 2022 to December 2022 were enrolled as CHF group,and 165 healthy subjects were selected as control group.Peripheral blood S1P was measured and 6MWD,LVEF was completed in all subjects.Person related was used to analyze the correlation between S1P expression,6MWD and LVEF in peripheral blood of CHF patients.The clinical data,LVEF,6MWD and S1P of peripheral blood were compared between the two groups of different prognosis.Logistics analysis was performed to analyze the influencing factors of the prognosis of CHF patients,and receiver operating characteristic curve(ROC)was used to evaluate the predictive value of 6MWD and S1P for the prognosis of CHF patients.Results The expression of S1P and 6MWD,LVEF in peripheral blood of CHF group were significantly lower than those of control group(P<0.05).S1P expression in peripheral blood of CHF patients was positively correlated with LVEF(P<0.05),and 6MWD was positively correlated with LVEF(P<0.05).The proportion of coronary heart disease in CHF patients with good prognosis was significantly lower than that in patients with poor prognosis,and S1P,6 MWD and LVEF were significantly higher than those in patients with poor prognosis(P<0.05).Logistics regression analysis showed that S1P and 6 MWD were prognostic factors in CHF patients(P<0.05).The area under the curve of S1P and 6 MWD for predicting the prognosis of CHF was 0.897 and 0.793,respectively,and the cutoff values were 0.459 and 0.634,respectively,corresponding to sensitivities of 68.6%and 79.3%,and specificities of 52.7%and 46.9%.The area under the curve of the combination of the two for predicting the prognosis of CHF was 0.941,and its sensitivity and specificity were 85.1%and 71.4%,respectively.Conclusion S1P

关 键 词：1-磷酸鞘氨醇 6分钟步行试验距离 慢性心力衰竭 预后 预测价值 

分 类 号：R541.6[医药卫生—心血管疾病]