老年慢性心力衰竭病人血清suPAR、MSTN水平与心功能和预后的关系

doi:10.3969/j.issn.1003-9198.2022.01.017

摘要/Abstract

摘要： 目的探讨老年慢性心力衰竭(CHF)病人血清可溶性尿激酶型纤溶酶原激活物受体(suPAR)、肌肉生长抑制素(MSTN)水平及其与心功能和预后的关系。方法选取2017年1月至2019年6月我科收治的CHF病人120例为观察组,同期选取我院体检健康志愿者100例为对照组。采用酶联免疫吸附法检测2组血清suPAR、MSTN水平。出院后随访1年,根据CHF病人是否发生心血管不良事件分为预后不良组(n=32)及预后良好组(n=88)。绘制ROC曲线,分析血清suPAR、MSTN对CHF病人不良预后的预测价值。结果观察组血清suPAR、MSTN水平较对照组明显升高,差异有统计学意义(P<0.05)。不同心功能分级病人血清suPAR、MSTN、氨基末端脑钠肽原(NT-proBNP)、LVEF水平比较,差异有统计学意义(P<0.05)。Pearson相关性分析示:血清suPAR、MSTN与NT-proBNP呈正相关,与LVEF呈负相关(均P<0.05)。预后不良组血清suPAR、MSTN、NT-proBNP、LVEF水平与预后良好组相比,差异有统计学意义(P<0.05)。ROC曲线示,血清suPAR、MSTN及两项联合检测预测病人不良预后的灵敏度分别为0.785、0.754、0.908,特异度分别为0.743、0.716、0.779,AUC分别为0.867、0.815、0.912。结论老年CHF病人血清suPAR、MSTN水平明显升高,其与病人的心功能分级及临床预后密切相关,联合检测血清suPAR、MSTN对老年CHF病人的预后判断有较高临床价值,可作为病情的监测指标。

关键词: 慢性心力衰竭, 可溶性尿激酶型纤溶酶原激活物受体, 肌肉生长抑制素

Abstract: Objective To explore the serum levels of soluble urokinase-type plasminogen activator receptor (suPAR) and myostatin (MSTN) in the elderly patients with chronic heart failure(CHF) and their relationship with cardiac function and prognosis. Methods A total of 120 patients with CHF admitted to our department from January 2017 to June 2019 were selected as observation group. In the same period, another 100 healthy volunteers were selected as control group in our hospital. Enzyme-linked immunosorbent assay was used to detect the serum levels of suPAR and MSTN for the two groups. The CHF patients were followed up for 1 year after discharge, and were divided into poor prognosis group (n=32) and good prognosis group (n=88) according to whether the patients had cardiovascular adverse events. Receiver operating characteristic (ROC) curve was performed to analyze the predictive value of serum suPAR and MSTN for the poor prognosis of the CHF patients. Results The levels of serum suPAR, MSTN in the observation group were significantly higher than those in the control group (P<0.05). There were statistically significant differences in serum levels of suPAR, MSTN, N-terminal pro B type natriuretic peptide (NT-proBNP), and left ventricular ejection fraction (LVEF) between different cardiac function classes (P<0.05). Pearson correlation analysis showed that the serum levels of suPAR and MSTN were positively correlated with NT-proBNP, and negatively correlated with LVEF (all P<0.05). The serum levels of suPAR, MSTN, NT-proBNP and LVEF in the poor prognosis group were significantly different from those in the good prognosis group (P<0.05). The ROC curve showed that the sensitivities of serum suPAR, MSTN and the combined detections to predict the poor prognosis of the patients were 0.785, 0.754, 0.908, and the specificities were 0.743, 0.716, 0.779, and the areas under the curve were 0.867, 0.815, 0.912, respectively. Conclusions The serum levels of suPAR and MSTN in the elderly patients with CHF are significantly increased, which are closely related to the patients’ cardiac function classification and clinical prognosis. The combined detection of serum suPAR and MSTN has a high clinical value for the prognosis of the elderly patients with CHF, and can be used as a monitoring indicator of the patient’s condition.

Key words: chronic heart failure, soluble urokinase-type plasminogen activator receptor, myostatin

中图分类号:

R 541.6

安素, 蒋芸璐, 王华英, 黄国鹏, 陶黎. 老年慢性心力衰竭病人血清suPAR、MSTN水平与心功能和预后的关系[J]. 实用老年医学, 2022, 36(1): 65-68.

AN Su, JIANG Yun-lu, WANG Hua-ying, HUANG Guo-peng, TAO Li. Serum levels of suPAR and MSTN in elderly patients with chronic heart failure and their relationship with cardiac function and prognosis[J]. Practical Geriatrics, 2022, 36(1): 65-68.

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