心力衰竭患者血浆CTRP6、SIRI水平及临床意义  

Plasma CTRP6 and SIRI levels in patients with heart failure and their clinical significance

作　　者：马家慧 王忠[2] MA Jiahui;WANG Zhong(Shihezi University School of Medicine,Shihezi 832003,Xinjiang,China;The Second Department of Cardiology,the First Affiliated Hospital of Shihezi University,Shihezi 832008,Xinjiang,China)

机构地区：[1]石河子大学医学院,新疆石河子832003 [2]石河子大学第一附属医院心血管二科,新疆石河子832008

出　　处：《中国现代医生》2025年第9期29-32,46,共5页China Modern Doctor

摘　　要：目的探究心力衰竭(heart failure,HF)患者血浆C1q/肿瘤坏死因子相关蛋白6(C1q/tumor necrosis factor-related protein 6,CTRP6)和系统性炎症反应指数(systemic inflammation response index,SIRI)水平及临床意义。方法选取2023年10月至2024年9月石河子大学第一附属医院心脏中心收治的HF患者126例,根据左心室射血分数(left ventricular ejection fraction,LVEF)分为射血分数降低的心力衰竭(heart failure with reduced ejection fraction,HFrEF)组(n=43)、射血分数轻度降低的心力衰竭(heart failure with mildly reduced ejection fraction,HFmrEF)组(n=45)、射血分数保留的心力衰竭(heart failure with preserved ejection fraction,HFpEF)组(n=38),选取同期就诊的非HF患者作为对照组(n=38)。收集患者的血常规、N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、超声心动图参数,计算SIRI和左心室质量指数(left ventricular mass index,IVMI);采用酶联免疫吸附法检测血浆CTRP6水平,分析HF患者的CTRP6、SIRI与LVEF、IVMI、NT-proBNP、纽约心脏协会心功能分级的相关性,Logistic回归分析法分析HF的危险因素,绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)。结果与对照组比较,HF患者的肌酐、尿酸、估算肾小球滤过率、SIRI水平升高,合并冠心病、房颤的比例升高,CTRP6水平降低,差异有统计学意义(P<0.05);不同射血分数分型HF患者的CTRP6、NT-proBNP、LVEF、IVMI差异有统计学意义(P<0.05);Spearman相关性分析显示HF患者的CTRP6与LVEF呈正相关,与LVMI呈负相关;SIRI与NT-proBNP呈正相关,与LVEF呈负相关。Logistic回归分析显示CTRP6是HF的独立保护因素,CTRP6降低是HF严重程度的独立危险因素。CTRP6、SIRI及二者联合诊断HF的ROC曲线下面积分别为0.762、0.772、0.850。结论HF患者血浆CTRP6水平显著降低,SIRI显著升高,二者对HF均具有良好的诊断价值,且二者联合检测可提高诊断效能。Objective To investigate the plasma levels of C1q/tumor necrosis factor-related protein 6(CTRP6)and systemic inflammation response index(SIRI)in patients with heart failure(HF)and their clinical significance.Methods 126 HF patients admitted to the Heart Center,the First Affiliated Hospital of Shihezi University from October 2023 to September 2024 were selected and divided into heart failure with reduced ejection fraction(HFrEF)group(n=43),heart failure with mildly reduced ejection fraction(HFmrEF)group(n=45)and heart failure with preserved ejection fraction(HFpEF)group(n=38)according to left ventricular ejection fraction(LVEF)value.Non-HF patients treated at the same period were selected as the control group(n=38).Blood routine,N-terminal pro-B-type natriuretic peptide(NT-proBNP)and echocardiogram parameters were collected,SIRI and left ventricular mass index(IVMI)were calculated,plasma CTRP6 levels were detected by enzyme-linked immunosorbent assay,and the correlation between CTRP6,SIRI and LVEF,IVMI,NT-proBNP and New York Heart Association grades in HF patients was analyzed.Risk factors of HF were analyzed by Logistic regression analysis and receiver operating characteristic(ROC)curve was drawn.Results Compared with control group,HF patients showed statistically significant increases in creatinine,uric acid,estimate glomerular filtration rate,and SIRI levels,as well as a higher proportion of patients with coronary heart disease and atrial fibrillation.Conversely,CTRP6 levels were decreased,with statistical significance(P<0.05).There were statistical differences in CTRP6,NT-proBNP,LVEF and IVMI of HF patients with different ejection fraction classification(P<0.05).Spearman correlation analysis showed that CTRP6 level was positively correlated with LVEF and negatively correlated with LVMI in HF patients.SIRI was positively correlated with NT-proBNP and negatively correlated with LVEF.Logistic regression analysis indicates that CTRP6 is independent protective factor for HF,and a decrease in CTRP6 is an independent

关 键 词：C1q/肿瘤坏死因子相关蛋白6 系统性炎症反应指数 心力衰竭 左心室重构 左心室射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]