本文選題：慢性心力衰竭　切入點(diǎn)：組織型金屬蛋白酶抑制劑　出處：《山東醫(yī)藥》2017年36期 　論文類型：期刊論文

【摘要】：目的探討血清組織型金屬蛋白酶抑制劑4(TIMP-4)水平對老年慢性心力衰竭(CHF)早期診斷及預(yù)后評估的價(jià)值。方法選擇老年CHF患者160例(CHF組),其中輕度68例、重度92例,另選體檢健康的老年志愿者40例(對照組)。采用彩色多普勒超聲診斷儀檢測兩組左心室舒張末期內(nèi)徑(LVEDD)、左心室射血分?jǐn)?shù)(LVEF)。采集肘靜脈血,采用雙抗體夾心ELISA法檢測血清TIMP-4。采用受試者工作特征(ROC)曲線分析血清TIMP-4對老年CHF的早期診斷價(jià)值。老年CHF患者出院3、6、9個(gè)月復(fù)查心臟彩超,統(tǒng)計(jì)心臟事件的發(fā)生情況。結(jié)果 CHF組LVEDD明顯高于對照組,LVEF、TIMP-4明顯低于對照組,以重度CHF患者上述指標(biāo)變化更明顯(P均0.05);相關(guān)分析顯示,老年CHF患者血清TIMP-4水平與LVEF呈正相關(guān)關(guān)系(r=0.816,P0.05),與LVEDD呈負(fù)相關(guān)關(guān)系(r=-0.266,P0.05)。ROC曲線分析顯示,血清TIMP-4診斷老年CHF的曲線下面積為0.916(95%CI:0.869~0.951),其cut off值為1.41 ng/m L,此時(shí)血清TIMP-4診斷老年CHF的敏感性為77.0%、特異性為92.0%。以血清TIMP-4水平的cut off值為截?cái)嘀?將老年CHF患者分為TIMP-4高水平者(TIMP-41.41ng/m L)46例和TIMP-4低水平者(TIMP-4≤1.41 ng/m L)114例;TIMP-4高水平者和TIMP-4低水平者出院3個(gè)月無心臟事件生存率比較P0.05,而TIMP-4高水平者出院6、9個(gè)月無心臟事件生存率明顯高于TIMP-4低水平者(P均0.05)。結(jié)論血清TIMP-4可作為老年CHF患者早期診斷和預(yù)后判斷的預(yù)測指標(biāo)之一。
[Abstract]:Objective to investigate the value of serum tissue metalloproteinase inhibitor (TIMP-4) in the early diagnosis and prognosis evaluation of chronic heart failure (CHF) in the elderly. The left ventricular end-diastolic diameter (LVEDDN), left ventricular ejection fraction (LVEF) and left ventricular ejection fraction (LVEF) were detected by color Doppler ultrasound in 40 healthy volunteers (control group). The serum TIMP-4 was detected by double antibody sandwich ELISA. The value of serum TIMP-4 in the early diagnosis of senile CHF was analyzed by using the operating characteristics of the subjects. Results the incidence of cardiac events in CHF group was significantly higher than that in control group, especially in severe CHF patients (P < 0.05). There was a positive correlation between serum TIMP-4 level and LVEF in elderly patients with CHF. There was a negative correlation between serum TIMP-4 level and LVEDD. The area under the curve of serum TIMP-4 in the diagnosis of senile CHF was 0.916 / 95 CI: 0.869 / 0.951 and the value of cut off was 1.41 ng/m / L. the sensitivity and specificity of serum TIMP-4 in the diagnosis of senile CHF were 77.0 and 92.0 respectively. The cut off value of serum TIMP-4 level was taken as truncation value. Elderly patients with CHF were divided into high TIMP-4 patients with TIMP-41.41ngP / mL and low TIMP-4 patients with TIMP-4 鈮，

本文編號：1591946