层粘连蛋白对急性心力衰竭预后的预测价值  

Predictive value of laminin level for the prognosis of acute heart failure

作　　者：叶佳琦 严晓云 姜英 陈芸 张清[1] YE Jiaqi;YAN Xiaoyun;JIANG Ying;CHEN Yun;ZHANG Qing(Department of General Practice,Nantong First People’s Hospital,Nantong 226001,China)

机构地区：[1]南通市第一人民医院全科医学科,江苏省南通市226001

出　　处：《实用老年医学》2025年第4期391-394,共4页Practical Geriatrics

基　　金：南京医科大学康达学院科研发展基金课题(KD2022KYJJZD021);南通大学临床专项课题(2022JZ006);南通市卫生健康委科研课题(MS2022017)。

摘　　要：目的探讨血清层粘连蛋白(LN)对急性心力衰竭(AHF)预后的预测价值。方法选取2019年7月至2020年11月于南通市第一人民医院心内科住院的238例老年AHF病人,收集基线资料以及院内主要不良心血管事件(MACE)的发生情况。根据是否发生MACE将老年AHF病人分为事件组及非事件组,比较2组间基线资料的差异;采用多因素logistic回归分析探讨MACE发生的独立影响因素。采用ROC曲线评价LN对老年AHF病人预后的预测价值。结果238例老年AHF病人中53例发生MACE。事件组与非事件组比较,氨基末端脑利钠肽前体(NT-proBNP)、LN、透明质酸、Ⅲ型前胶原肽、肌酐、CRP、左室舒张末期直径、左室收缩末期直径、收缩压、甘胆酸、LVEF和急性失代偿性心力衰竭比例差异有统计学意义(P<0.05)。多因素logistic回归分析显示,LN水平升高、LVEF降低是MACE的独立影响因素。LN预测老年AHF病人院内发生MACE的ROC曲线下面积为0.742,最佳阈值为92.5 ng/mL,敏感度为59.6%,特异度为77.1%。结论LN可作为预测老年AHF病人院内预后的潜在标志物。Objective To investigate the predictive value of serum laminin(LN)level for the prognosis of acute heart failure(AHF)in the elderly.Methods A total of 238 elderly patients with AHF admitted to Nantong First People’s Hospital from July 2019 to November 2020 were enrolled in this study.The baseline data and the occurrence of major adverse cardiovascular event(MACE)were recorded and collected.Based on the occurrence of MACE,the patients were divided into event group and non-event group.The differences in the baseline data between the two groups were analyzed.Multiple logistic regression analysis was used to investigate the influencing factors of MACE.Receiver operating characteristic(ROC)curve analysis was used to investigate the predictive value of LN for prognosis.Results There were 53 patients presenting with MACE.The levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),LN,hyaluronic acid,aminoterminal propeptide of typeⅢprocollagen,creatinine,C-reactive protein(CRP),left ventricular end-diastolic diameter,left ventricular end-systolic diameter,systolic blood pressure,glycocholic acid and left ventricular ejection fraction(LVEF),and the proportion of acute decompensated heart failure showed significant differences between event group and non-event group(P<0.05).The levels of LN and LVEF were the independent influencing factors of MACE.The area under the ROC curve of LN in predicting in-hospital MACE in the elderly patients with AHF was 0.742,with cut-off point of 92.5 ng/mL,sensitivity of 59.6%,specificity of 77.1%(P<0.001).Conclusions LN may serve as a potential biomarker to predict the in-hospital prognosis in the elderly patients with AHF.

关 键 词：急性心力衰竭 氨基末端脑利钠肽前体 层粘连蛋白 院内预后 

分 类 号：R541.6[医药卫生—心血管疾病]