[1]曹　雷a,汪隆海a,周　梅a,等.慢性肾心综合征患者血清9项心衰标志物水平联合检测的实验诊断价值研究[J].现代检验医学杂志,2021,36(05):90-94.[doi:10.3969/j.issn.1671-7414.2021.05.020]
　CAO Leia,WANG Long-haia,ZHOU Meia,et al.Study on Experimental Diagnostic Value for Combined Detection of 9 HeartFailure Markers in Serum of Patients with Chronic Renal Heart Syndrome[J].Journal of Modern Laboratory Medicine,2021,36(05):90-94.[doi:10.3969/j.issn.1671-7414.2021.05.020]
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慢性肾心综合征患者血清9项心衰标志物水平联合检测的实验诊断价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年05期
页码:
90-94
栏目:
论　著
出版日期:
2021-10-14

文章信息/Info

Title:
Study on Experimental Diagnostic Value for Combined Detection of 9 HeartFailure Markers in Serum of Patients with Chronic Renal Heart Syndrome
文章编号:
1671-7414（2021）05-090-06
作者:
曹　雷1a; 汪隆海2a; 周　梅1a; 张求霞2a; 黄　飞2a; 姜中伟1b; 姜中云2b; 郑海波1c; 高　欢2c; 等
（1. 合肥市第八人民医院a. 检验科；b. 肾内科；c. 心内科；d. 血液透析科；e. 超声诊断科；f. 病理科，安徽巢湖238000；2. 宋庆龄爱心医院a. 检验科；b. 肾内科；c. 心内科；d. 血液透析科；e. 超声诊断科；f. 病理科，安徽巢湖238000）
Author(s):
CAO Lei1a; WANG Long-hai2a; ZHOU Mei1a; ZHANG Qiu-xia2a; HUANG Fei2a; JIANG Zhong-wei1b; JIANG Zhong-yun2b; ZHENG Hai-bo1c; GAO Huan2c; YE Yang-mei1d; LI Jie2d; TANG Zeng-shan1e; SONG Chuan2e; CHENG Kai-fang1f; CAI Qian-yi2f
（1a. Department of Clinical Laboratory；1b. Department of Nephrology；1c. Department of Cardiology；1d.Department of Hemodialysis；1e. Department of Ultrasonic Diagnosis；1f. Department of Pathology, Hefei EighthPeople’s Hospital，Anhui Chaohu 238000，China；2a. Department of Clinical Laboratory；2b. Departmentof Nephrology；2c. Department of Cardiology；2d. Department of Hemodialysis；2e. Department of UltrasonicDiagnosis；2f. Department of Pathology, Song Qingling Caring Hospital，Anhui Chaohu 238000，China）
关键词:
心衰标志物; 心肾综合征; 慢性肾脏病
分类号:
R541.6；R446.112
DOI:
10.3969/j.issn.1671-7414.2021.05.020
文献标志码:
A
摘要:
目的　探讨血清9项心衰标志物对慢性肾心综合征（被称为Ⅳ型心肾综合征，CRS-4）的比较分析与优选出的4项心衰标志物对CRS-4的诊断价值。方法　测定47例CRS-4患者、55例慢性肾脏病（CKD）患者和61例健康体检者的血清9项心衰标志物，并用IBM SPSS 25.0与SAS 9.4软件进行统计处理。结果　CRS-4患者的血清NT-proBNP，中段心房利钠肽原（MR-proANP），可溶性致癌抑制因子-2（sST2），生长分化因子-15（GDF-15），大内皮素-1（Big ET-1），和肽素（CPP），肾上腺髓质中段肽（MR-proADM），半乳糖凝集素-3（Gal-3）和五聚素3（PTX3）结果均明显高于CKD患者和健康者，差异均有统计学意义（F=83.186~221.422，均P=0.000）。它们的ROC曲线下面积分别为0.954，0.992，0.954，0.982，0.965，0.964，0.924，0.947和0.959。用血清NT-proBNP≥984 ng/L，MR-proANP≥376 pmol/L，sST2≥20.35μg/L，GDF-15≥273.5 ng/L，Big ET-1≥3.95 pmol/L，CPP≥15.65 pmol/L，MR-proADM≥655.5 pmol/L，Gal-3≥28.6μg/L和PTX3≥5.05μg/L的9项中的2项诊断CRS-4，敏感度、特异度和诊断符合率分别为97.87%，96.83%和97.27%。典型相关分析选出的血清sST2，GDF-15，BigET-1和Gal-3检测，对CRS-4的诊断效能最大。结论　在CKD患者中定期联合检测血清NT-proBNP，MR-proANP，sST2，GDF-15，Big ET-1，CPP，MR- proADM，Gal-3和PTX3水平将能尽早发现CRS-4患者，有较高的敏感度和特异度及较好的诊断符合率。
Abstract:
Objective　To investigate the comparative analysis of 9 serum heart failure markers for chronic renal heart syndrome（referred to as type 4 cardiorenal syndrome，CRS-4）and the diagnostic value of 4 selected heart failure markers for CRS-4.Methods　9 heart failure markers were detected in 47 patients with CRS-4, 55 patients with chronic kidney disease (CKD) and61 healthy subjects, and the results were statistically analyzed by using IBM SPSS 25.0 and SAS 9.4 statistical software. Results　Theresults of serum N-terminal pro-brain natriuretic peptide(NT-proBNP),midregional pro-atrial natriuretic peptide(MR-proANP),soluble suppression of tumorigenicity-2(sST2), growth differentiation factor-15(GDF-15), big endothelin-1(Big ET-1),copeptin(CPP), midregional pro-adrenomedullin (MR-proADM),galectin-3(Gal-3) and pentraxin-3(PTX3) in CRS-4 patientswere significantly higher than those in CKD patients and healthy subjects, the differences were statistically significant（F=83.186~221.422，all P=0.000）. Their receiver operator characteristic curve (ROC) showed that area under curve (AUC)were 0.954, 0.992, 0.954, 0.982, 0.965, 0.964, 0.924, 0.947 and 0.959, respectively.Diagnosis of CRS-4 was performed usingserum NT-proBNP ≥ 984 ng/L，MR-proANP ≥ 376 pmol/L，sST2 ≥ 20.35μg/L，GDF-15 ≥ 273.5 ng/L，Big ET-1 ≥ 3.95 pmol/L，CPP ≥ 15.65 pmol/L，MR-proADM ≥ 655.5 pmol/L，Gal-3 ≥ 28.6μg/L and PTX3 ≥ 5.05μg/L in 9items 2. The sensitivity , specificity and diagnostic coincidence rate were 97.87%, 96.83% and 97.27% respectively with theirtwo results to diagnose CRS-4. Serum sST2, GDF-15, BigET-1 and Gal-3 selected by canary correlation analysis showed thehighest diagnostic efficiency for CRS-4. Conclusion　In patients with CKD, regular combined detection of serum NT-proBNP,MR-PROANP, SST2, GDF-15, Big ET-1, CPP, MR-PROADM, Gal-3 and PTX3 levels will lead to early detection of CRS- 4patients.They have higher sensitivity，specificity and better diagnostic coincidence rate.

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备注/Memo

备注/Memo:
作者简介：曹 雷（1964-），男，本科，副主任检验技师，研究方向：临床化学，E-mail：403648560@qq.com。
更新日期/Last Update: 1900-01-01