老年慢性心力衰竭病人血清富半胱氨酸蛋白61水平的临床意义

doi:10.3969/j.issn.1003-9198.2025.07.007

摘要/Abstract

摘要： 目的探讨老年CHF病人血清富半胱氨酸蛋白61(cysteine-rich angiogenic inducer 61,CCN1)水平与CHF严重程度的相关性。方法选择老年CHF病人136例为病例组,按 NYHA心功能分级分为Ⅱ级、Ⅲ级、Ⅳ级3个亚组,同时选取老年健康体检者29例作为对照组。采用ELISA法检测受试者血清中CCN1以及氨基末端脑钠肽前体(NT-proBNP)水平;采用Pearson相关分析评估CCN1水平与NT-proBNP及LVEF的相关性,采用多因素logistic回归分析NYHA心功能Ⅲ~Ⅳ级的独立相关因素,绘制ROC曲线评价血清CCN1水平对NYHA心功能Ⅲ~Ⅳ级的预测价值。结果老年CHF病人血清CCN1水平显著高于对照组(P＜0.01),且CCN1水平随CHF严重程度的增加而升高。Pearson相关分析显示,老年CHF病人血清CCN1水平与NT-proBNP水平呈正相关(r=0.662, P<0.001),与LVEF 呈负相关(r=－0.493, P <0.001)。多因素logistic回归分析结果显示,在校正其他临床变量后,CCN1是NYHA心功能Ⅲ~Ⅳ级的独立影响因素(OR=1.124, 95%CI:1.034~1.254, P=0.012)。ROC曲线分析显示,血清CCN1对NYHA心功能Ⅲ~Ⅳ级有较好的预测价值,AUC为0.959(95%CI:0.917～0.984),对应的切点值为2.826 pg/mL,敏感度为91.3%,特异度为90.3%,约登指数为0.816。结论血清CCN1水平或可作为评估老年CHF病情严重程度的潜在标志物。

关键词: 慢性心力衰竭, 富半胱氨酸蛋白61, 氨基末端脑钠肽前体

Abstract: Objective To explore the relationship between the serum level of cysteine-rich angiogenic inducer 61 (CCN1) and the severity of chronic heart failure (CHF) in the elderly patients. Methods A total of 136 elderly patients with CHF were enrolled as case group and divided into Ⅱ, Ⅲ, Ⅳ subgroups according to the cardiac function class of New York Heart Association (NYHA). During the same period, 29 healthy elderly individuals were selected as control group. Serum levels of CCN1 and N-terminal pro-brain natriuretic peptide(NT-proBNP)of the two groups were detected by enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was performed to evaluate the associations of CCN1 with NT-proBNP and left ventricular ejection fraction (LVEF). Multivariate logistic regression analysis was used to identify independent factors associated with NYHA grade Ⅲ-Ⅳ. The predictive value of serum CCN1 for NYHA grade Ⅲ-Ⅳ was evaluated by receiver operating characteristic (ROC) curve. Results Serum level of CCN1 was significantly increased in case group compared to control group(P<0.01), and was increased progressively with worsening CHF severity. Pearson analysis indicated that the level of serum CCN1 was positively correlated with NT-proBNP(r=0.662, P <0.001), whereas negatively correlated with LVEF(r=－0.493, P<0.001). Multivariate logistic regression analysis showed that CCN1 was independently associated with NYHA cardiac function class Ⅲ-Ⅳ after adjusting for other clinical variables (OR=1.124, 95%CI: 1.034－1.254, P=0.012). The ROC curve showed that serum CCN1 level had a good predictive value for NYHA grade Ⅲ-Ⅳ (AUC=0.959, 95%CI:0.917－0.984,P<0.001), with an ideal cutoff value of 2.826 pg/mL, sensitivity of 91.3%, specificity of 90.3% and Youden index of 0.816. Conclusions The serum level of CCN1 may act as a potential indicator to evaluate the severity of CHF in the elderly.

Key words: chronic heart failure, cysteine-rich angiogenic inducer 61, N-terminal pro-brain natriuretic peptide

中图分类号:

R541.6

左广锋, 谢浩, 闫玉峰, 郑亚国, 林松. 老年慢性心力衰竭病人血清富半胱氨酸蛋白61水平的临床意义[J]. 实用老年医学, 2025, 39(7): 681-685.

ZUO Guangfeng, XIE Hao, YAN Yufeng, ZHENG Yaguo, LIN Song. Clinical significance of serum level of cysteine-rich angiogenic inducer 61 in elderly patients with chronic heart failure[J]. Practical Geriatrics, 2025, 39(7): 681-685.

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