ALB、sST2、TS及三者联合对射血分数保留的心力衰竭患者发生冠状动脉狭窄的预测价值  

Predictive Value of ALB,sST2,TS and Their Combination for Coronary Stenosis in Patients with Heart Failure with Preserved Ejection Fraction

作　　者：胡泽宇 卢艳辉 李文英[1] 叶青[1] 邹冰 叶佩芝 HU Zeyu;LU Yanhui;LI Wenying;YE Qing;ZOU Bing;YE Peizhi(Department of Electrophysiology,the Third Hospital of Changsha/the Affiliated Changsha Hospital of Hunan University,Changsha 410035,China)

机构地区：[1]湖南省长沙市第三医院、湖南大学附属长沙医院电生理科,410035

出　　处：《实用心脑肺血管病杂志》2025年第6期42-46,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：湖南省卫生健康委科研计划项目(D202305136214)。

摘　　要：目的探讨白蛋白(ALB)、可溶性致瘤性抑制蛋白2(sST2)、震荡斜率(TS)及三者联合对射血分数保留的心力衰竭(HFpEF)患者发生冠状动脉狭窄的预测价值。方法选取2020年12月—2023年1月长沙市第三医院收治的111例HFpEF患者作为研究对象。收集患者的临床资料,根据冠状动脉狭窄发生情况将患者分为冠状动脉狭窄组与非冠状动脉狭窄组。采用多因素Logistic回归分析探讨HFpEF患者发生冠状动脉狭窄的影响因素。采用Spearman秩相关分析探讨ALB、sST2、TS与HFpEF患者冠状动脉血流储备分数(FFR)的相关性。绘制ROC曲线以分析ALB、sST2、TS及三者联合对HFpEF患者发生冠状动脉狭窄的预测价值。结果111例患者中,发生冠状动脉狭窄33例,发生率为29.73%。冠状动脉狭窄组ALB低于非冠状动脉狭窄组,sST2高于非冠状动脉狭窄组,TS、最小管腔直径小于非冠状动脉狭窄组,管腔狭窄率大于非冠状动脉狭窄组(P<0.05)。多因素Logistic回归分析结果显示,ALB、sST2、TS、管腔狭窄率是HFpEF患者发生冠状动脉狭窄的独立影响因素(P<0.05)。Spearman秩相关分析结果显示,ALB、TS与HFpEF患者冠状动脉FFR均呈正相关(r s值分别为0.265、0.354,P值分别为0.005、<0.001),sST2与其冠状动脉FFR呈负相关(r s=-0.362,P<0.001)。ROC曲线分析结果显示,ALB、sST2、TS及三者联合预测HFpEF患者发生冠状动脉狭窄的AUC分别为0.800〔95%CI(0.721~0.879)〕、0.741〔95%CI(0.624~0.858)〕、0.717〔95%CI(0.604~0.829)〕、0.892〔95%CI(0.830~0.955)〕;三者联合预测HFpEF患者发生冠状动脉狭窄的AUC分别高于ALB、sST2、TS单独预测对应的AUC(P<0.05)。结论ALB、sST2、TS是HFpEF患者发生冠状动脉狭窄的独立影响因素,其中ALB、TS与HFpEF患者冠状动脉狭窄程度呈负相关,sST2与其呈正相关,且ALB、sST2、TS对HFpEF患者发生冠状动脉狭窄均具有一定预测价值,三者联合的预测价值更高。Objective To explore the predictive value of albumin(ALB),soluble suppression of tumorigenicity 2(sST2),turbulence slope(TS)and their combination for coronary stenosis in patients with heart failure with preserved ejection fraction(HFpEF).Methods From December 2020 to January 2023,a total of 111 patients with HFpEF admitted to the Third Hospital of Changsha were selected as the research objects.Clinical data of patients were collected.According to the occurrence of coronary stenosis,patients were divided into coronary stenosis group and non-coronary stenosis group.Multivariate Logistic regression analysis was used to explore the influencing factors of coronary stenosis in patients with HFpEF.Spearman rank correlation analysis was used to explore the correlation between ALB,sST2,TS and fractional flow reserve(FFR)of coronary artery in patients with HFpEF.ROC curve was drawn to analyze the predictive value of ALB,sST2,TS and their combination for coronary stenosis in patients with HFpEF.Results Among 111 patients,33 cases occurred coronary stenosis,the incidence rate was 29.73%.ALB in coronary stenosis group was lower than that in non-coronary stenosis group,sST2 was higher than that in non-coronary stenosis group,TS and minimum lumen diameter were smaller than those in non-coronary stenosis group,and lumen stenosis rate was larger than that in non-coronary stenosis group(P<0.05).Multivariate Logistic regression analysis showed that ALB,sST2,TS and lumen stenosis rate were independent influencing factors of coronary stenosis in patients with HFpEF(P<0.05).Spearman rank correlation analysis showed that ALB,TS were both positively correlated with FFR of coronary artery in HFpEF patients(r s values were 0.265,0.354,P valus were 0.005,<0.001,respectively),while sST2 was negatively correlated with FFR of coronary artery(r s=-0.362,P<0.001).ROC curve analysis showed that the AUC of ALB,sST2,TS and their combination in predicting coronary stenosis in patients with HFpEF was 0.800[95%CI(0.721-0.879)],0.741[95%CI(0.624-0.85

关 键 词：心力衰竭 冠状动脉狭窄 白蛋白 可溶性致瘤性抑制蛋白2 震荡斜率 

分 类 号：R541.62[医药卫生—心血管疾病]