血清Ghrelin、ANGPTL4联合老年营养风险指数对老年慢性肺心病患者的预后预测价值  

Prognostic value of serum Ghrelin,ANGPTL4 combined with Geriatric Nutritional Risk Index in elderly patients with chronic pulmonary heart disease

作　　者：薛军 于晶晶 薛明月 李小龙 XUE Jun;YU Jingjing;XUE Mingyue;LI Xiaolong(Department of Respiratory and Critical Care Medicine,Hai′an People′s Hospital,Hai′an,Jiangsu 226600,China)

机构地区：[1]江苏省海安市人民医院呼吸与危重症医学科,江苏海安226600

出　　处：《国际检验医学杂志》2025年第9期1046-1050,共5页International Journal of Laboratory Medicine

基　　金：江苏省2020年度医院管理创新研究项目(JSYGY-3-2020-153)。

摘　　要：目的探讨血清生长素释放肽(Ghrelin)、血管生成素样蛋白4(ANGPTL4)联合老年营养风险指数(GNRI)对老年慢性肺心病(CPHD)患者的预后预测价值。方法选取2019年1月至2022年1月该院收治的老年CPHD患者98例为CPHD组,另选同期健康体检者98例为对照组。采用酶联免疫吸附试验(ELISA)测定血清Ghrelin、ANGPTL4水平;采用多因素Logistic回归分析老年CPHD患者预后的影响因素;绘制受试者工作特征(ROC)曲线分析血清Ghrelin、ANGPTL4联合GNRI在CPHD预后的预测价值。结果与对照组比较,CPHD组血清Ghrelin水平、GNRI显著降低(P<0.05),ANGPTL4水平显著升高(P<0.05)。与生存组比较,死亡组GNRI、Ghrelin水平显著降低(P<0.05),ANGPTL4水平显著升高(P<0.05)。多因素Logistic回归分析,ANGPTL4是影响老年CPHD患者预后的危险因素(P<0.05),Ghrelin、GNRI是影响老年CPHD患者预后的保护因素(P<0.05)。ROC结果显示,血清Ghrelin、ANGPTL4、GNRI三者联合预测老年CPHD患者预后的曲线下面积(AUC)最大,优于血清Ghrelin、ANGPTL4、GNRI各自单独预测(P<0.05)。结论老年CPHD患者血清Ghrelin水平降低,ANGPTL4水平升高,二者联合GNRI可更好地预测CPHD患者预后,具有较高的预测价值。Objective To explore the prognostic value of serum growth hormone releasing peptide(Ghrelin),angiopoietin like protein 4(ANGPTL4)combined with Geriatric Nutritional Risk Index(GNRI)in elderly patients with chronic pulmonary heart disease(CPHD).Methods From January 2019 to January 2022,a total of 98 elderly patients with CPHD admitted to the Hai'an People's Hospital were selected as the CPHD group,and another 98 healthy individuals who underwent physical examinations were selected as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to determine the levels of serum Ghrelin and ANGPTL4.Multivariate Logistic regression was applied to analyze the influencing factors of prognosis in elderly patients with CPHD.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum Ghrelin,ANGPTL4 combined with GNRI in the prognosis of CPHD.Results Compared with the control group,the level of serum Ghrelin and GNRI in the CPHD group were obviously reduced(P<0.05),while the level of ANGPTL4 was obviously increased(P<0.05).Compared with the survival group,the GNRI and Ghrelin level in the death group were obviously reduced(P<0.05),while the level of ANGPTL4 was obviously increased(P<0.05).Multivariate Logistic regression results showed that ANGPTL4 was a risk factor affecting the prognosis of elderly CPHD patients(P<0.05),while Ghrelin and GNRI were protective factors affecting the prognosis of elderly CPHD patients(P<0.05).ROC curve results showed that the combination of serum Ghrelin,ANGPTL4,and GNRI had the largest area under the curve(AUC)in predicting the prognosis of elderly CPHD patients,which was better than that of the individual predictions of serum Ghrelin,ANGPTL4,and GNRI(P<0.05).Conclusion The level of serum Ghrelin decreases and the level of ANGPTL4 increases in elderly patients with CPHD.The combination of the two with GNRI could better predict the prognosis of CPHD patients and has high predictive value.

关 键 词：血清生长素释放肽 血管生成素样蛋白4 老年 慢性肺心病 预后 预测 

分 类 号：R541.5[医药卫生—心血管疾病]