SDC1、NT-proBNP在慢性心力衰竭患者血清中的表达水平及其临床意义

doi:10.3969/j.issn.1671-7171.2022.05.008

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摘要【目的】探讨多配体蛋白聚糖1(SDC1)与N端脑钠肽前体(NT-proBNP)在慢性心力衰竭(CHF)患者血清中的表达水平及其临床意义。【方法】选取本院115例CHF患者作为观察组,根据2021年欧洲心脏病学会急慢性心力衰竭诊断和治疗指南,将其分为射血分数保留组(HFpEF组,n=40)、射血分数轻度降低组(HFmrEF组,n=40)、射血分数降低组(HFrEF组,n=35)三组。另外收集同期在本院体检的健康志愿者35例为对照组。比较各组血清SDC1及NT-proBNP水平;Logistic回归分析CHF的危险因素;受试者工作特征(ROC)曲线分析SDC1、NT-proBNP及两者联合对CHF的诊断价值。【结果】观察组患者血清SDC1、NT-proBNP水平均显著高于对照组,其差异具有统计学意义(P<0.05); HFrEF组、HFmrEF组、HFpEF组患者血清NT-proBNP水平依次降低,组间比较差异有统计学有意义(P<0.05);HFpEF组血清SDC1水平低于HFmrEF组、HFrEF组(P<0.05),但HFmrEF与HFrEF组血清SDC1水平比较,差异无统计学意义 (P>0.05)。Logistic回归分析显示:SDC1升高、NT-proBNP升高、左室射血分数(LVEF)下降及左房内径(LAD)升高是CHF的独立危险因素(均P<0.05);ROC曲线分析显示:NT-proBNP诊断CHF的曲线下面积(AUC)为0.855, SDC1诊断CHF的AUC为0.808,二者联合诊断CHF的AUC为0.896。【结论】CHF患者血清中SDC1、NT-proBNP水平升高,SDC1、NT-proBNP对CHF均有诊断价值,但单一的SDC1诊断效能不如NT-proBNP,两者联合应用可提高对CHF的诊断效能。

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	骆晗
	欧阳泽伟

关键词 ：心力衰竭, 慢性病, 利钠肽,脑/血液

Abstract：【Objective】 To investigate the serum levels and significance of N-terminal pro-brain natriuretic peptide (NT-proBNP) and Syndecan-1 (SDC1) in patients with chronic heart failure (CHF). 【Methods】 We selected 115 hospitalization patients with CHF in our hospital as the CHF group. The CHF group was further divided into 3 subgroups based on the 2021 ESC (European Society of Cardiology) guidelines for the diagnosis and treatment of acute and chronic heart failure: preserved ejection fraction (HFpEF, n=40), mildly reduced ejection fraction (HFmrEF, n=40) and reduced ejection fraction group (HFrEF, n=35).At the same time, 35 volunteers with normal cardiac function were selected as the control group. Statistical analysis was conducted on the differences of serum SDC1 and NT-proBNP levels among the three subgroups with CHF and the control group. Logistic regression was used to analyze the risk factors of CHF. ROC curve was used to analyze the diagnostic value of SDC1, NT-proBNP alone and combination for CHF. 【Results】 Compared to the control group, the CHF groups had significantly higher levels of both SDC1 and NT-proBNP. The difference was statistically significant (P<0.05). The serum levels of NT-proBNP in the HFrEF group, HFmrEF group and HFpEF group were decreased in turn, and the difference between the groups was statistically significant (P<0.05). Serum SDC1 level in HFpEF group was lower than that in HFmrEF group and HFrEF group (P<0.05), however, there was no significant difference in serum SDC1 level between HFmrEF and HFrEF group (P>0.05). Logistic regression analysis showed that high levels of SDC1, NT-proBNP and LAD and low LVEF were independent risk factors for CHF. The area under the curve (AUC) of NT-proBNP and SDC1 in the diagnosis of CHF were 0.855 and 0.808, respectively, whereas the area under the curve of combined application of the two indexes in the diagnosis was 0.896. 【Conclusion】 The serum levels of SDC1 and NT-proBNP in patients with CHF increased, and the combined application of both SDC1 and NT-proBNP can improve the diagnostic value for CHF.

Key words： Heart Failure Chronic Disease Natriuretic Peptide, Brain/BL

收稿日期: 2022-01-04

中图分类号:

R541.61

引用本文:

骆晗, 欧阳泽伟. SDC1、NT-proBNP在慢性心力衰竭患者血清中的表达水平及其临床意义[J]. 医学临床研究, 2022, 39(5): 667-670.
LUO Han, OUYANG Ze-wei. Variations and Significance of Serum Syndecan-1 and N-terminal Pro-brain Natriuretic Peptide in Patients with Chronic Heart Failure. JOURNAL OF CLINICAL RESEARCH, 2022, 39(5): 667-670.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.05.008 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I5/667

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