發(fā)布時(shí)間：2018-08-26 11:09

【摘要】：目的觀察慢性心力衰竭(Chronic heart failure CHF)患者血漿中可溶性ST2(s ST2)的水平變化,并探討其臨床意義。方法收集寧夏醫(yī)科大學(xué)心血管病醫(yī)院心血管內(nèi)科2014年10月至2015年10月收住的慢性心力衰竭患者100例(心衰組)和同期無(wú)器質(zhì)性疾病體檢者30例(對(duì)照組);所有心力衰竭患者均符合我國(guó)最新版心力衰竭診療指南規(guī)定的診斷標(biāo)準(zhǔn);心衰組按紐約心臟病協(xié)會(huì)(NYHA)心功能分級(jí)分為心功能Ⅱ級(jí)組、Ⅲ級(jí)組和Ⅳ級(jí)組,分別為35例、32例及33例,按左室射血分?jǐn)?shù)(LVEF)水平分為射血分?jǐn)?shù)降低(HFrEF)組52例和射血分?jǐn)?shù)保留(HFpEF)組48例。采用酶聯(lián)免疫吸附測(cè)定(ELISA)法檢測(cè)血漿sST2、腦利鈉肽(BNP)水平,常規(guī)超聲心動(dòng)圖測(cè)定左室射血分?jǐn)?shù)(LVEF)、左室舒張末期內(nèi)徑(LVDd)、收縮末期內(nèi)徑(LVDs)及左室短軸縮短率(LVFS),比較不同分組患者血漿sST2水平的變化,并分析其與腦鈉尿肽、NYHA分級(jí)及心臟超聲各個(gè)指標(biāo)的相關(guān)性。結(jié)果1、血漿sST2水平經(jīng)對(duì)數(shù)轉(zhuǎn)換后在NYHAⅡ~Ⅳ級(jí)組明顯高于對(duì)照組(3.00±0.08;3.06±0.12;3.08±0.10 VS 2.91±0.13),各組間多重比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05);2、Log sST2在HFpEF組、HFrEF組均高于對(duì)照組(3.02±0.09;3.07±0.12 VS 2.91±0.13)(P0.05),各組間多重比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05);3、Pearson相關(guān)性分析顯示,經(jīng)對(duì)數(shù)轉(zhuǎn)換后的血漿sST2(Log sST2)與經(jīng)對(duì)數(shù)轉(zhuǎn)換后的血漿BNP(Log BNP)、NYHA分級(jí)、LVDd、LVDs呈正相關(guān)(r=0.454、0.480、0.462、0.454,P均0.01),與LVEF、LVFS呈負(fù)相關(guān)(r=-0.409、-0.396,P均0.01)。結(jié)論(1)慢性心衰患者血漿sST2水平均明顯升高,且隨著心衰嚴(yán)重程度的增加而逐漸升高,與NYHA分級(jí)呈正相關(guān)。(2)血漿sST2水平與BNP、左室舒張末期內(nèi)徑、左室收縮末期內(nèi)徑呈正相關(guān),與左室射血分?jǐn)?shù)、左室短軸縮短率呈負(fù)相關(guān)。(3)血漿sST2可以作為心臟彩超及BNP的有效補(bǔ)充,具有潛在的臨床應(yīng)用價(jià)值。
[Abstract]:Objective to observe the changes of plasma soluble ST2 (s ST2) levels in patients with chronic heart failure (Chronic heart failure CHF) and to explore its clinical significance. Methods from October 2014 to October 2015, 100 patients with chronic heart failure (CHF group) and 30 patients without organic diseases (control group) were collected from Cardiovascular Department, Ningxia Medical University. All patients with power failure met the diagnostic criteria stipulated in the latest edition of the guidelines for the diagnosis and treatment of heart failure in China. The heart failure group was divided into three groups according to the (NYHA) cardiac function classification of the New York Heart Association: class 鈪，

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