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Gal-3、sST-2和BNP在预测左心室射血分数保留心力衰竭患者主要心血管不良事件的临床价值

  

  1. 上海中医药大学附属曙光医院 急诊科,上海  200021
  • 出版日期:2020-02-20 发布日期:2020-03-24
  • 通讯作者: 李黎, Email:watercuplily@hotmail.com

Clinical value of Gal3,  sST2,  and BNP in heart failure patients with preserved ejection fraction  in predicting major cardiovascular adverse events

  1. Department of Emergency,  Shuguang Hospital  affiliated to Shanghai University of  Traditional Chinese Medicine,  Shanghai 200021, China
  • Online:2020-02-20 Published:2020-03-24
  • Contact: Corresponding author: Li Li, Email:watercuplily@hotmail.com

摘要: 目的  观察血清半乳糖凝集素3(Gal3)、可溶性抑瘤作用2(sST2)和脑钠肽(BNP)在预测射左心室射血分数保留心力衰竭(HfpEF)患者主要心血管不良事件(MACE)的临床价值。方法  我院诊断和治疗的HfpEF患者126例,为HfpEF组。选择同期在我院健康体检者60例,为健康对照组。血清Gal3、sST2和 BNP水平的检测采用酶联免疫吸附实验。观察两组血清Gal3、sST2、BNP、LAVI和LVEF变化,与心功能分级和MACE发生关系,及HfpEF患者血清Gal3、sST2和BNP血清在预测MACE灵敏度和特异度。结果   HfpEF组血清Gal3、sST2、BNP和LAVI水平明显高于健康对照组(P<0.01),并随着心衰分级升高而升高。HfpEF患者MACE组的血清Gal3、sST2、BNP和LAVI水平明显高于非MACE组(P<0.01)。HFpEF患者血清Gal3、sST2和 BNP水平在预测不良事件方面具有较高的灵敏度和特异度,联合3个指标(Gal3+ sST2+ BNP)在预测主要心血管不良事件具有更高的诊断效能,其灵敏度为96.4%,特异度为91.8%,其曲线下面积(AUC)明显高于Gal3(Z=3.328,P<0.01)、sST2(Z=2.316,P<0.01)和BNP(Z=2.985,P<0.01)。结论  血清Gal3、sST2和 BNP水平与HfpEF疾病的严重程度相关,对预测MACE发生具有重要临床价值。

关键词: 心力衰竭,  , 充血性, 半乳糖凝集素3, 脑钠肽, 每搏输出量

Abstract: Objective  To observe the clinical value of galectin3 (Gal3),  soluble suppression of tumorigenicity2 (sST2),  and brain natriuretic peptide (BNP) in heart failure with preserved ejection fraction (HfpEF) in predicting major cardiovascular adverse events(MACE).Methods  A total of 126 patients diagnosed as HfpEF and treated in our hospital were selected as HfpEF group,  and 60 healthy people who underwent physical examination in our hospital during the same period were selected as healthy control group. The serum Gal3,  sST2 and BNP levels were measured by enzymelinked immunosorbent assay (ELISA). The serum Gal3,  sST2,  BNP,  LAVI,  and LVEF were compared between two groups,  the relation among the levels of the items,  cardiac function classification and MACE,  and the sensitivity and specificity of serum Gal3,  sST2 and BNP  in predicting MACE    were also observed.Results  The levels of serum Gal3,  sST2,  BNP and LAVI in HfpEF group were significantly higher than those in healthy control group (P<0.01), and the levels increased as the rise of heart failure classification(P<0.01). The serum Gal3,  sST2,  BNP,  and LAVI in MACE group in patients with HfpEF were significantly higher than those in nonMACE group (P<0.01). The serum Gal3,  sST2 and BNP in patients with HFpEF had higher sensitivity and specificity in predicting MACE. Combined detection (Gal3+sST2+BNP) in predicting MACE had higher diagnostic efficiency,  its sensitivity and specificity were 96.4% and 91.8%,  respecticely. And its area under the curve (AUC) was significantly higher than Gal3 (Z=3.328, P<0.01),  sST2(Z=2.316, P<0.01) and BNP (Z=2.985, P<0.01). Conclusion  The serum Gal3, sST2 and BNP levels are related to the severity of HfpEF, and have important clinical value in predicting MACE.

Key words: heart failure, , congestive;galectin3, brain natriuretic peptide;stroke volume