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sST2在急性心力衰竭诊断中的应用及对短期预后的评估价值
作者:张翥  范修才  陶亮亮 
单位:南通大学附属建湖医院 心内科, 江苏 盐城 224700
关键词:急性心力衰竭 可溶性生长刺激表达基因蛋白2 氨基末端脑钠肽前体 受试者工作特征曲线 诊断 预后 
分类号:R540.4
出版年·卷·期(页码):2021·49·第三期(317-320)
摘要:

目的:探讨血浆可溶性生长刺激表达基因蛋白2(sST2)水平在急性心力衰竭诊断中的应用及对患者短期预后的评估价值。方法:选取2016年9月至2017年11月间在我院心血管内科收治的78例初诊急性心力衰竭患者为观察组,同一时间段内因胸痛就诊而冠状动脉造影正常的患者60例为对照组,测定血浆sST2和氨基末端脑钠肽前体(NT-proBNP)水平,分析其对急性心力衰竭的诊断价值。再根据sST2水平将观察组分为高水平组(40例)和低水平组(38例),记录随访180 d内的主要不良心血管事件的发生情况,评估血浆sST2水平在急性心力衰竭短期临床预后中的价值。结果:观察组患者血浆sST2和NT-proBNP水平显著高于对照组,差异有统计学意义(P<0.001)。随访180 d发现高水平组不良心血管事件发生率明显高于低水平组,差异有统计学意义(P<0.001)。受试者工作特征(ROC)曲线分析显示,sST2和NT-proBNP水平两项联合检测的曲线下面积大于单项指标检测。Logistic回归分析显示sST2是影响AHF患者短期预后的独立危险预测因子(P<0.05)。结论:sST2可作为诊断急性心力衰竭的生物标志物,与NT-proBNP联合检测可提高对急性心力衰竭的诊断价值,同时血浆sST2水平对急性心力衰竭患者短期预后具有较高的临床评估价值。

参考文献:

[1] MIRO O,PEACOCK F W,MCMURRAY J J,et al.European Society of Cardiology-Acute Cardiovascular Care Association position paper on safe discharge of acute heart failure patients from the emergency department[J].Eur Heart J Acute Cardiovasc Care,2017,6(4):311-320.
[2] JANUZZI J J,FELKER G M.Surfing the biomarker tsunami at JACC:heart failure[J].JACC Heart Fail,2013,1(3):213-215.
[3] VAN KIMMENADE R R,JANUZZI J J.Emerging biomarkers in heart failure[J].Clin Chem,2012,58(1):127-138.
[4] OREMUS M,DON-WAUCHOPE A,MCKELVIE R,et al.BNP and NT-proBNP as prognostic markers in persons with chronic stable heart failure[J].Heart Fail Rev,2014,19(4):471-505.
[5] JANUZZI J L,MEBAZAA A,DI SOMMA S.ST2 and prognosis in acutely decompensated heart failure:the International ST2 Consensus Panel[J].Am J Cardiol,2015,115(7 Suppl):26B-31B.
[6] CLYDE Y,MARIELL J,BIYKEM B,et al.2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure:an update of the 2013 ACCF/AHA guideline for the management of heart failure:a report of the American College of Cardiology Foundation/American Heart Association Task Force on clinical practice guidelines and the heart failure society of America[J].Circulation,2016,134(13):e282-93.
[7] MUKHERJI A,ANSARI U,BORGGREFE M,et al.Clinically relevant biomarkers in acute heart failure:an update[J].Curr Pharm Biotechnol,2017,18(6):482-490.
[8] PASCUAL-FIGAL D A,JANUZZI J L.The biology of ST2:the International ST2 Consensus Panel[J].Am J Cardiol,2015,115(7 Suppl):3B-7B.
[9] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98-122.
[10] ROSSANO J W.Clinical management of patients with acute heart failure[J].Cardiol Young,2015,25(Suppl 2):67-73.
[11] FARMAKIS D,PARISSIS J,LEKAKIS J,et al.Acute heart failure:Epidemiology,risk factors,and prevention[J].Rev Esp Cardiol (Engl Ed),2015,68(3):245-248.
[12] WEINBERG E O,SHIMPO M,DE KEULENAER G W,et al.Expression and regulation of ST2,an interleukin-1 receptor family member,in cardiomyocytes and myocardial infarction[J].Circulation,2002,106(23):2961-2966.
[13] JANUZZI J J,PEACOCK W F,MAISEL A S,et al.Measurement of the interleukin family member ST2 in patients with acute dyspnea:results from the PRIDE (Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department) study[J].J Am Coll Cardiol,2007,50(7):607-613.
[14] OSHIKAWA K,KUROIWA K,TAGO K,et al.Elevated soluble ST2 protein levels in sera of patients with asthma with an acute exacerbation[J].Am J Respir Crit Care Med,2001,164(2):277-281.
[15] WU A H,WIANS F,JAFFE A.Biological variation of galectin-3 and soluble ST2 for chronic heart failure:implication on interpretation of test results[J].Am Heart J,2013,165(6):995-999.
[16] BOISOT S,BEEDE J,ISAKSON S,et al.Serial sampling of ST2 predicts 90-day mortality following destabilized heart failure[J].J Card Fail,2008,14(9):732-738.
[17] PFISTER R,TAN D,THEKKANAL J,et al.Predictors of elevated NT-pro-BNP in cardiovascular patients without acute heart failure[J].Int J Cardiol,2009,131(2):277-280.
[18] MUELLER T,DIEPLINGER B,GEGENHUBER A,et al.Increased plasma concentrations of soluble ST2 are predictive for 1-year mortality in patients with acute destabilized heart failure[J].Clin Chem,2008,54(4):752-756.
[19] REHMAN S U,MUELLER T,JANUZZI J J.Characteristics of the novel interleukin family biomarker ST2 in patients with acute heart failure[J].J Am Coll Cardiol,2008,52(18):1458-1465.

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