| 赵娟,卢海龙,杨雪,高卉,林天素,杨荣礼.血清可溶性生长刺激表达基因2蛋白、N末端脑钠肽前体、神经酰胺风险评分联合Fried衰弱量表对老年慢性心力衰竭患者预后的评估价值[J].中华老年多器官疾病杂志,2023,22(1):29~34 |
| 血清可溶性生长刺激表达基因2蛋白、N末端脑钠肽前体、神经酰胺风险评分联合Fried衰弱量表对老年慢性心力衰竭患者预后的评估价值 |
| Predictive value of serum sST2, NT-proBNP and CERT score combined with Fried frailty scale for prognosis of elderly patients with chronic heart failure |
| 投稿时间：2022-08-03 |
| DOI：10.11915/j.issn.1671-5403.2023.01.006 |
| 中文关键词: 老年人 可溶性生长刺激表达基因2蛋白 N末端脑钠肽前体 神经酰胺评分 衰弱 慢性心力衰竭 |
| 英文关键词:aged soluble growth stimulation expressed gene 2 N-terminal pro-brain natriuretic peptide ceramide test frailty chronic heart failure This work was supported by the Project of Xuzhou Science and Technology Bureau |
| 基金项目:徐州市科技局资助课题(KC16SH078) |
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| 中文摘要: |
| 目的 探讨血清可溶性生长刺激表达基因2蛋白(sST2)、N末端脑钠肽前体(NT-proBNP)、神经酰胺风险(CERT)评分联合Fried衰弱量表对老年慢性心力衰竭(CHF)患者预后的评估价值。方法 回顾性分析2020年7月至2021年7月于徐州医科大学附属医院收治住院治疗的304例老年慢性心力衰竭患者的临床资料。随访1年,根据随访期间是否发生不良心血管事件(MACE)将患者分为MACE组(76例)和非MACE组(228例)。比较2组患者血清sST2、NT-proBNP、CERT评分及衰弱的差异。采用SPSS 25.0统计软件进行数据分析。根据数据类型,分别采用t检验、秩和检验或χ2检验进行组间比较。采用Spearman相关分析左心室射血分数(LVEF)与sST2、NT-proBNP、CERT评分等指标的相关性。采用logistic回归分析MACE的影响因素。绘制受试者工作特征曲线(ROC),分析血清sST2、NT-proBNP、CERT评分及衰弱对老年慢性心力衰竭患者预后的评估价值。结果 sST2、NT-proBNP、CERT评分与LVEF呈负相关(r=-0.241,-0.193,-0.183；P＜0.05)。与非MACE组比较,MACE组患者sST2、NT-proBNP、CERT评分、衰弱比例更高,LVEF值更低,差异均有统计学意义(P＜0.05)。ROC曲线分析显示,血清sST2、NT-proBNP水平、CERT评分、衰弱对CHF患者预后不良的预测的曲线下面积(AUC)分别为0.695、0.713、0.636、0.658,四项联合预测AUC为0.800。结论 血清sST2、NT-proBNP、CERT评分及衰弱是老年CHF患者发生MACE的重要影响因素,具有较高的预后预测价值,且联合预测价值更高。 |
| 英文摘要: |
| Objective To investigate the assessment value of serum soluble growth stimulation expressed gene 2 (sST2), N-terminal pro-brain natriuretic peptide(NT-proBNP) and ceramide test (CERT) score combined with Fried frailty scale in evaluating the prognosis of chronic heart failure (CHF) in elderly patients. Methods A retrospective study was conducted on the 304 elderly CHF patients who were hospitalized in the Affiliated Hospital of Xuzhou Medical University from July 2020 to July 2021. According to whether major adverse cardiovascular events (MACE) occurred during the follow-up period of 1 year, they were divided into MACE group(76 cases) and non-MACE group(288 cases). The serum sST2, NT-proBNP, CERT score and frailty status were compared between the two groups. SPSS statistics 25.0 was used for data analysis. Based on the data type, student′s t test, rank sum test or Chi-square test was employed for intergroup comparison. Spearman correlation was applied to analyze the correlation of left ventricular ejection fraction (LVEF) with sST2, NT-proBNP, CERT score and other indicators. The influencing factors of MACE were analyzed by logistic regression analysis. Receiver operating characteristic (ROC) curve was drawn to analyze the prognostic value of serum sST2, NT proBNP, CERT scores and frailty status in elderly CHF patients. Results Serum sST2, NT-proBNP and CERT score were negatively correlated with LVEF (r=-0.241, -0.193, -0.183; P<0.05). The MACE group had higher sST2, NT-proBNP and CERT score, larger proportion of frail patients, and lower LVEF when compared with the non-MACE group (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of poor prognosis of CHF patients predicted by serum sST2, NT-proBNP, CERT scores and frailty were 0.695,0.713,0.636 and 0.658, respectively, and the AUC of combined prediction was 0.800. Conclusion Serum sST2, NT-proBNP, CERT score and frailty are important factors affecting the occurrence of MACE in elderly patients with CHF. They have high prognostic value, and even higher prognostic value when combined together. |
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