[1]张卫东,乔明刚.老年心衰并发心律失常患者血清Ang-2，CysC水平及hs-CRP/PAB比值对临床预后评估的价值研究[J].现代检验医学杂志,2021,36(06):128-131.[doi:10.3969/j.issn.1671-7414.2021.06.027]
　ZHANG Wei-dong,QIAO Ming-gang.Value of Serum Ang-2, Cys C and Hs-CRP/PAB Ratio in the Evaluation of Clinical Prognosis in Elderly Patients with Heart Failure Complicated by Arrhythmia[J].Journal of Modern Laboratory Medicine,2021,36(06):128-131.[doi:10.3969/j.issn.1671-7414.2021.06.027]
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老年心衰并发心律失常患者血清Ang-2，CysC水平及hs-CRP/PAB比值对临床预后评估的价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年06期
页码:
128-131
栏目:
论　著
出版日期:
2021-12-15

文章信息/Info

Title:
Value of Serum Ang-2, Cys C and Hs-CRP/PAB Ratio in the Evaluation of Clinical Prognosis in Elderly Patients with Heart Failure Complicated by Arrhythmia
文章编号:
1671-7414（2021）06-128-05
作者:
张卫东; 乔明刚
（蓬莱市人民医院检验科,山东蓬莱 265600)
Author(s):
ZHANG Wei-dong;  QIAO Ming-gang
（Department of Clinical Laboratory， Penglai People’s Hospital，Shandong Penglai 265600，China）
关键词:
血管生成素2; 胱抑素; 超敏C反应蛋白; 前清蛋白; 慢性心力衰竭
分类号:
R541.6；R446.112
DOI:
10.3969/j.issn.1671-7414.2021.06.027
文献标志码:
A
摘要:
目的　探究老年慢性心力衰竭（CHF）并发心律失常患者血清血管生成素2（Ang-2）、胱抑素C（Cys C）和超敏C反应蛋白/前清蛋白（hs-CRP/PAB）比值对患者预后的评估价值。方法　选取2017年1月～2020年1月蓬莱市人民医院收治的117例老年CHF并发心律失常患者，按照NYHA分级分为NYHAⅡ组（n=34），NYHA Ⅲ组（n=52）和NYHAⅣ组（n=31），另选同期体检健康人员37例作为健康对照组，采用ELISA法测定血清Ang-2水平，采用化学发光微粒子免疫法检测BNP，采用免疫比浊法检测Cys C，hs-CRP和PAB水平。收集患者临床资料，记录出院后6个月是否发生心衰复发或心源性死亡（SCD）。采用单因素方差分析比较不同NYHA分级患者血清Ang-2，CysC和hs-CRP/PAB差异，采用Pearson及Spearman检验分析血清Ang-2，Cys C，hs-CRP/PAB与BNP，LVEF，NYHA分级相关性，建立ROC曲线分析血清Ang-2，Cys C和hs-CRP/PAB对预测CHF预后的临床价值。结果　各病例组血清Ang-2，Cys C，hs-CRP/PAB，BNP高于对照组，LVEF低于对照组，且以上指标在不同NYHA分级患者中差异均有统计学意义（F=7.98，8.27，8.36，8.55，9.74，均P<0.05）；Pearson相关性分析显示，血清Ang-2，Cys C，hs-CRP/PAB与BNP呈正相关（r=0.635，0.448，0.649，均P<0.05），与LVEF呈负相关（r=-0.571，-0.645，-0.627，均P<0.05），Spearman相关性分析显示，血清Ang-2，Cys C和hs-CRP/PAB与NYHA分级呈正相关（r=0.713，0.633，0.584，均P<0.05）；预后不良患者血清Ang-2，hs-CRP/PAB，Cys C高于预后良好患者，差异均有统计学意义（t=2.953，3.738，9.768，均P<0.05）；绘制血清Ang-2，Cys C和hs-CRP/PAB预测预后的ROC曲线，其AUC分别为0.713，0.737和0.670，联合检测的AUC为0.860。结论　老年心律失常型心衰患者血清Ang-2，CysC和hs-CRP/PAB表达与其病情严重程度有关，且对临床预后具有一定的预测价值。
Abstract:
Objective　To investigate the value of angiopoietin 2 (Ang-2), cystatin C (Cys C), hypersensitive C-reactive protein/prealbumin (hs-CRP/PAB) ratio in the evaluation of elderly patients with chronic heart failure (CHF) combined with arrhythmia. Methods　A total of 117 elderly CHF patients with arrhythmia admitted to Penglai People’s Hospital from January 2017 to January 2020 were selected and divided into NYHAⅡ group (n=34), NYHAⅢ group (n=52) and NYHAⅣgroup (n=31) according to NYHA classification, and 37 healthy people during the same period were selected as healthy controls. Serum Ang-2 levels were determined by ELISA, BNP was detected by chemiluminescence microparticle immunoassay, and Cys C, hs-CRP and PAB levels were detected by immunoturbidimetric method. The clinical data of patients were collected, to recorded whether heart failure recurrence or cardiac death (SCD) occurred 6 months after discharge. The differences of serum Ang-2, Cys C and hs-CRP/PAB in patients with different NYHA grades were compared by one-way ANOVA Pearson and Spearman tests were used to analyze the correlation between serum Ang-2, Cys C, hs-CRP/PAB and BNP, LVEF, NYHA grades. ROC curve was established to analyze the clinical value of serum Ang-2, Cys C and hs-CRP/PAB in predicting the prognosis of CHF. Results　Serum Ang-2, Cys C, hs-CRP/PAB and BNP in each case group were higher than those in the control group, and LVEF was lower than the control group. Those values were significantly different in patients with various NYHA grade (F=7.98，8.27，8.36，8.55，9.74, all P<0.05). Pearson correlation analysis showed that serum Ang-2, Cys C, hs-CRP/PAB and BNP were positively correlated (r=0.635, 0.448, 0.649, all P<0.05), and negatively correlated with LVEF (r=-0.571, -0.645, -0.627, P<0.05). Spearman correlation analysis showed that serum Ang-2, Cys C and hs-CRP/PAB were positively correlated with NYHA grade (r=0.713, 0.633, 0.584, all P<0.05), and serum Ang-2, CysC and hs-CRP/PAB in patients with poor prognosis were higher than those with good prognosis (t=2.953，9.768，3.738, all P<0.05).The ROC curves of serum Ang-2, Cys C and hs-CRP/PAB to predict prognosis were plotted. The AUCs were 0.713, 0.737 and 0.670, respectively, and the combined AUC was 0.860. Conclusion　Expressions of serum Ang-2, Cys C and hs-CRP/PAB in elderly patients with chronic heart failure are related to its diease conditions, and have a certain predictive value for their clinical prognosis.

参考文献/References:

[1] 王宙, 周琳, 刘洋, 等. 慢性心力衰竭的流行病学研究现状及其防治研究进展[J]. 中国循证心血管医学杂志,2019,11(8):1022-1024.WANG Zhou, ZHOU Lin, LIU Yang, et al. Currentsituation of epidemiology and prevention of chronicheart failure [J]. Chinese Journal of Evidence-BasesCardiovascular Medicine, 2019,11 (8): 1022-1024.
[2] G??ER H, KAYACIK G?NDAY ?, ?NAL M.The risk of arrhythmia by calculating with newelectrocardiographic parameters in pregnant womenwith heart failure[J]. Turkish Journal of Clinics andLaboratory, 2018, 9(4): 331-335.
[3] 刘冰, 张卫海, 傅强, 等.Cys C，NT-proBNP，cTnT在急性心力衰竭患者中的水平及其联合检测的诊断价值[J]. 心血管康复医学杂志,2018,27(3):282-286.LIU Bin, ZHANG Weihai, FU Qiang, et al. Levelsof Cys C ,NT-proBNP and cTnT in AHF patientsand diagnostic value of their combined detection[J].Chinese Journal of Cardiovascular RehabilitationMedicine, 2018, 27 (3): 282-286.
[4] 赵廷利, 孙启梅, 王辉. 心力衰竭患者血清sST2 及ANG-2 与Cys C 联合检测诊断效能研究[J]. 社区医学研究, 2019, 17(20): 1299-1302.ZHAO Tingli，SUN Qimei，WANG Hui. Study onthe diagnostic efficacy of serum sST2,Ang-2 and CysC in patients with heart failure[J]. J Community Med ,2019, 17(20): 1299-1302.
[5] 吴献豪, 刘宝宏.BNP 和Cys-C 检测在致心律失常右室发育不良患者心衰预测及预后评估中的价值[J]. 中国循证心血管医学杂志, 2018, 10 (5): 597-600.WU Xianhao, LIU Baohong. Value of brain natriureticpeptide and serum cystatin C in predicting heart failureand prognosis review in patients with arrhythmogenicright ventricular dysplasia [J]. Chinese Journal ofEvidence-Based Cardiovascular Medicine, 2018, 10(5): 597-600.
[6] 尚少红, 张红, 李湘. 血清Cystatin C，MMP-2 及hs-CRP/PAB 对急性心肌梗死患者PCI 术后并发心衰的预测价值[J]. 河北医药,2019,41(3):343-346,351.SHANG Shaohong, ZHANG Hong, LI Xiang. Predictivevalue of serum Cystatin C, MMP2 combined withhs-CRP/PAB ratio in patients with acute myocardial infartioncomplicated by heart failure after PCI[J]． HebeiMedical Journal,2019,41(3):343-346,351.
[7] HUNT S. 2009 update incorporated into the ACC/AHA2005 guidelines for the diagnosis and managementof heart failure in adults[J]. Journal of the AmericanCollege of Cardiology, 2009, 53(2): 164-170.
[8] 郭飞波.Cyp A, BNP, ET-1 浓度在老年慢性心衰患者中的表达及临床意义[J]. 现代检验医学杂志, 2016,31 (6): 88-91.GUO Feibo. Expression characteristics and clinicalsignificance of CypA,BNP and ET-1 in elderly patientswith chronic heart failure[J]. Journal of ModernLaboratory Medicine, 2016, 31 (6): 88-91.
[9] 马炜. 胺碘酮联合厄贝沙坦治疗心力衰竭合并心律失常的疗效及对心功能的影响[J]. 实用临床医药杂志,2018,22(13):42-44, 48.MA Wei. Effect of amiodarone combined with irbesartanon treatment of patients with heart failure andarrhythmia and its influence on cardiac function [J].Journal of Clinical Medicine in Practice, 2018, 22 (13):42-44, 48.
[10] 陈菲菲, 赵谊昶, 尹晓盟, 等. 慢性心力衰竭患者心脏再同步化治疗后心律失常导管消融现状[J]. 中华心血管病杂志, 2019, 47 (11): 927-930.CHEN Feifei, ZHAO Yichang，YIN Xiaomeng, etal. Current status of catheter ablation for arrhythmiaafter cardiac resynchronization therapy in patients withchronic heart failure [J]. Chinese Journal of Cardiology,2019, 47 (11): 927-930.
[11] BAZOUKIS G, LETSAS K P, TSE G, et al. Predictorsof arrhythmia recurrence in patients with heart failureundergoing left atrial ablation for atrial fibrillation[J].Clinical Cardiology, 2018, 41(1): 63-67.
[12] 李腾, 李宜富. 心房颤动合并心力衰竭患者: 导管消融获益的认识[J]. 内科急危重症杂志, 2018, 24 (6):447-448.LI Teng, LI Yifu. Patients with atrial fibrillation andheart failure: understanding the benefits of catheterablation [J]. Journal of Internal Intensive Medicine,2018, 24 (6): 447-448.
[13] 陈泽芳, 赖志杰, 辛延国, 等. 射血分数保留型心力衰竭合并心房颤动的发病机制及治疗进展[J]. 临床内科杂志, 2019 ,36(2): 142-144.CHEN Zefang, LAI Zhijie, XIN Yanguo, et al. Pathogenesisand treatment progress of heart failure withpreserved ejection fraction and atrial fibrillation [J].Journal of Clinical Internal Medicine, 2019 ,36(2): 142-144.
[14] OKABE T. Cardiac arrhythmia in heart failure[J].Encyclopedia of Cardiovascular Research andMedicine, 2018, 7(15): 394-410.
[15] 聂蔚卓, 丁超, 蔡青青, 等. 重组人脑利钠肽对慢性心力衰竭患者QTcd 及短期预后的影响[J]. 临床误诊误治, 2018, 31 (1): 97-100.NIE Weizhuo, DING Chao, CAI Qingqing, et al. Effectof recombinant human brain natriuretic peptide onQTcd and short-term prognosis of patients with chronicheart failure [J]. Clinical Misdiagnosis & Mistherapy,2018, 31 (1): 97-100.
[16] 周杰, 张智. 胺碘酮综合治疗重度心力衰竭并发快速心律失常疗效观察[J]. 医学临床研究, 2019，36(6):1216-1218.ZHOU Jie, ZHANG Zhi. Effect of amiodarone onsevere heart failure complicated with tachyarrhythmia[J]. Journal of Clinical Research, 2019,36 (6):1216-1218.
[17] DIMITROPOULOS G, LEVENTOGIANNIS G, DEBONO J. Decompensated heart failure with ventriculararrhythmia: how useful is VT ablation[J]. Current HeartFailure Reports, 2018, 15(4): 201-213.
[18] 刘玉, 周利民, 张军. 心率变异性对慢性心力衰竭病情评估及预后的应用价值[J]. 新疆医科大学学报,2018,41 (3): 291-294.LIU Yu, ZHOU Limin, ZHANG Jun. Application ofheart rate variability in assessment and prognosis ofchronic heart failure [J]. Journal of Xinjiang MedicalUniversity, 2018,41 (3): 291-294.
[19] 黄德嘉, 张澍. 慢性心力衰竭最佳药物治疗与心脏性猝死的预防[J].中华心律失常学杂志, 2018, 22 (1):4-7.HUANG Dejia, ZHANG Shu. Optimal medicaltherapy of chronic heart failure and prevention ofsudden cardiac death [J]. Chinese Journal of CardiacArrhythmias, 2018, 22 (1): 4-7.
[20] 浩日瓦, 娜日罕, 周红, 等. 血清microRNA126 和microRNA1 检测对心衰诊断价值的研究[J]. 现代检验医学杂志,2018,33(3):18-20, 23.HAO Riwa，NA Rihan，ZHOU Hong, et al. Study onthe diagnostic value of detecting serum microRNA126and microRNA1 in heart failure [J]. Journal of ModernLaboratory Medicine, 2018, 33 (3): 18-20，23.
[21] CHRISTIE S, HIEBERT B, SEIFER C M, et al.Clinical outcomes of cardiac resynchronization therapywith and without a defibrillator in elderly patients withheart failure[J]. Journal of Arrhythmia, 2019, 35(1): 61-69.
[22] 杨宏斌, 黄巧平. 老年心功能衰竭患者血清NTproBNP和hs-TnT 水平检测与NYHA 分级的相关性分析[J]．现代检验医学杂志, 2019, 34 (2): 64-67,71.YANG Hongbin, HUANG Qiaoping. Application ofcombined detection of serum NT-proBNP and hs-TnT by electrochemiluminescence in evaluation ofelderly patients with heart failure [J].Journal of ModernLaboratory Medicine, 2019, 34 (2): 64-67, 71.

备注/Memo

备注/Memo:
作者简介：张卫东（1966-），男，大专，主管检验技师，主要研究方向：临床检验，E-mail:zhaojixian198jix@163.com。
更新日期/Last Update: 1900-01-01