[1]安国印,陈润祥,吴晶晶,等.老年慢性心力衰竭患者血清LL37 和SSC5D 水平检测对预后的评估价值[J].现代检验医学杂志,2024,39(05):80-84+91.[doi:10.3969/j.issn.1671-7414.2024.05.015]
　AN Guoyin,CHEN Runxiang,WU Jingjing,et al.Prognostic Value of Serum LL37 and SSC5D Levels in Elderly Patients with Chronic Heart Failure[J].Journal of Modern Laboratory Medicine,2024,39(05):80-84+91.[doi:10.3969/j.issn.1671-7414.2024.05.015]
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老年慢性心力衰竭患者血清LL37 和SSC5D 水平检测对预后的评估价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年05期
页码:
80-84+91
栏目:
论著
出版日期:
2024-09-15

文章信息/Info

Title:
Prognostic Value of Serum LL37 and SSC5D Levels in Elderly Patients with Chronic Heart Failure
文章编号:
1671-7414（2024）05-080-06
作者:
安国印; 陈润祥; 吴晶晶; 廖占玲
（上海交通大学医学院附属苏州九龙医院心内科，江苏苏州 215000）
Author(s):
AN Guoyin;  CHEN Runxiang;  WU Jingjing ;  LIAO Zhanling
（Department of Cardiology, Suzhou Kowloon Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Jiangsu Suzhou 215000, China）
关键词:
抗菌肽LL37; 人可溶性富含半胱氨酸结构域的清道夫受体蛋白; 慢性心力衰竭
分类号:
R541.6；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.05.015
文献标志码:
A
摘要:
目的 探讨血清抗菌肽LL37（LL37）和人可溶性富含半胱氨酸结构域的清道夫受体蛋白（soluble scavengerreceptor cysteine-rich domain-containing protein，SSC5D）在老年慢性心力衰竭（chronic heart failure，CHF）中的表达及对预后的评估价值。方法 选取上海交通大学医学院附属苏州九龙医院2017 年1 月～ 2022 年1 月收治的100 例CHF患者为CHF 组，根据预后情况将患者分为预后良好组（n=60）和预后不良组（n=40）。另选取100 例健康体检者为对照组。酶联免疫吸附试验（ELISA）检测血清LL37 和SSC5D 水平。比较CHF 组和对照组血清LL37 和SSC5D 水平差异；Spearman 分析血清LL37 和SSC5D 相关性；Kaplan-Meier 生存曲线分析血清LL37 和SSC5D 表达与CHF患者预后的关系；COX 分析影响CHF 患者预后的因素。采用ROC 曲线分析血清LL37 和SSC5D 对老年CHF 患者预后不良的预测价值。结果 CHF组血清LL37（771.38±158.25 ng/ml）和SSC5D（15 789.35±1 306.25 pg/ml）水平高于对照组（526.23±115.58ng/ml，8 938.72±858.29 pg/ml），差异具有统计学意义（t=12.510，43.830，均P ＜ 0.001）。Spearman 相关性分析结果显示，CHF 患者血清LL37 与SSC5D 水平呈显著正相关(r=0.629，P ＜ 0.001)；CHF 患者血清LL37，SSC5D 水平与NYHA 心功能分级呈显著正相关(r=0.776，0.751，均P ＜ 0.001)。高水平LL37 组生存率显著低于低水平LL37 组（38.18% vs 86.67%），差异具有统计学意义（Log rank χ2=24.242，P ＜ 0.001）；高水平SSC5D 组生存率显著低于低水平SSC5D 组（37.74% vs 85.10%），差异具有统计学意义（Log rank χ2=23.291，P ＜ 0.001）。预后不良组＞ 70 岁占比、NYHA 心功能分级III+IV 级占比、血清LL37 和SSC5D 水平高于预后良好组，差异具有统计学意义（χ2=10.774，4.118，t=4.723，14.059，均P ＜ 0.05）。多因素COX 分析结果表明，年龄＞ 70 岁（OR=1.515，95%CI：1.224 ～ 1.858）、NYHA 心功能III+IV 分级（OR=1.236，95%CI：1.198 ～ 1.963）、高水平LL37（OR=1.705，95%CI：1.163 ～ 2.582）和高水平SSC5D（OR=1.591，95%CI：1.052 ～ 1.916）是影响CHF 患者预后的独立危险因素（均P ＜ 0.05）。ROC曲线分析显示，血清LL37 和SSC5D 联合预测老年CHF 预后不良的曲线下面积大于血清LL37 和SSC5D 单独检测，差异具有统计学意义（Z=2.834，2.168，P=0.005，0.030）。结论 CHF 患者血清LL37 和SSC5D 水平升高，两者均是CHF 患者预后不良危险因素，可作为临床评估CHF 预后指标。
Abstract:
Objective To investigate the expression and prognostic value of serum antimicrobial peptide LL37 and human soluble scavenger receptor cysteine-rich domain-containing protein (SSC5D) in elderly patients with chronic heart failure (CHF). Methods A total of 100 CHF patients admitted to Suzhou Kowloon Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2017 to January 2022 were selected as the CHF group. According to the prognosis, these patients were divided into good group (n=60) and poor prognosis group (n=40). Another 100 healthy examinees were selected as the control group. Enzyme-linked immunosorbent assay was used to detect serum levels of LL37 and SSC5D. The differences in serum LL37 and SSC5D levels between CHF group and control group were compared. Spearman correlation analysis was used to analyze the correlation between serum LL37 and SSC5D. Kaplan-Meier survival curve was used to analyze the relationship between serum LL37 and SSC5D expression and the prognosis of CHF patients. COX regression analysis was used to analyze the factors affecting the prognosis of CHF patients. ROC curve was used to analyze the predictive value of serum LL37 and SSC5D for poor prognosis in elderly CHF patients. Result The levels of serum LL37 (771.38±158.25 ng/ml) and SSC5D (15 789.35± 1 306.25 pg/ml) in CHF group were higher than those in control group (526.23±115.58 ng/ml, 8 938.72±858.29 pg/ml), and the differences were significant (t=12.510, 43.830, all P < 0.001). Spearman correlation analysis showed that there was a significant positive correlation between serum LL37 and SSC5D in CHF patients (r=0.629, P < 0.001). The serum LL37 and SSC5D levels in CHF patients were positively correlated with NYHA cardiac function classification (r=0.776, 0.751, all P < 0.001). The survival rate of the high-level LL37 group was lower than that of the low-level LL37 group (38.18% vs 86.67%), and the difference was significant (Log rank χ2=24.242，P < 0.001). The survival rate of the high level SSC5D group was lower than that of the low level SSC5D group (37.74% vs 85.10%), and the difference was significant (Log rank χ2=23.291, P < 0.001). Compared with the good prognosis group, the poor prognosis group had a higher proportion of patients over 70 years old, proportion of patients with NYHA cardiac function class III+IV, and serum LL37 and SSC5D levels, and the differences were significant (χ2=10.774, 4.118, t=4.723, 14.059, all P < 0.05). Multivariate COX analysis showed that age > 70 years (OR=1.515, 95%CI: 1.224 ～ 1.858), NYHA cardiac function class III+IV (OR=1.236, 95%CI: 1.198 ～ 1.963), high level of LL37 (OR=1.705, 95%CI: 1.163 ～ 2.582) and high level of SSC5D (OR=1.591, 95%CI: 1.052 ～ 1.916) were independent risk factors for the prognosis of CHF patients. ROC curve analysis showed that the area under the curve of serum LL37 combined with SSC5D for predicting poor prognosis of CHF in the elderly was larger than that of serum LL37 and SSC5D alone, and the differences were significant (Z=2.834, 2.168, P=0.005, 0.030). Conclusion The serum LL37 and SSC5D levels are increased in patients with CHF, and both are risk factors for poor prognosis in patients with CHF, which can be used as clinical indicators to evaluate the prognosis of CHF.

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备注/Memo

备注/Memo:
基金项目：江苏省卫生健康委医学科研课题（S2020029）。
作者简介：安国印（1987-），男，硕士，主任医师，研究方向：心力衰竭、冠心病，E-mail：agy112233445566@163.com。
通讯作者：陈润祥（1972-），男，硕士研究生，研究方向：心律失常、心力衰竭。
更新日期/Last Update: 2024-09-15