射血分数降低的心力衰竭患者血清可溶性ST2、BNP水平动态变化及其对预后的预测价值OA
Dynamic changes of serum soluble ST2 and BNP levels in heart failure patients with reduced ejection fraction and their predictive value on prognosis
目的 探讨射血分数降低的心力衰竭(HFrEF)患者血清可溶性生长刺激表达基因 2 蛋白(sST2)、脑钠肽(BNP)水平动态变化及其对预后的预测价值.方法 选取HFrEF患者80 例为HFrEF组,按入院时心功能分级不同分为心功能Ⅱ级组(n=27)、心功能Ⅲ组(n=26)、心功能Ⅳ组(n=27),另选35 例健康体检者作为对照组.HFrEF组患者根据随访结果分为预后良好组(66 例)与预后不良组(14 例).比较HFrEF组与对照组一般资料;比较心功能Ⅱ级组、心功能Ⅲ组、心功能Ⅳ组、对照组血清sST2、BNP 水平;比较预后良好组与预后不良组不同时间血清sST2、BNP 水平.采用Spearman相关性检验分析HFrEF患者心功能分级与血清sST2、BNP水平的关系;采用ROC曲线分析血清sST2、BNP水平对HFrEF患者预后的预测价值.结果 HFrEF组合并高血压、糖尿病占比高于对照组(P<0.05),LVEF低于对照组(P<0.05).不同心功能分级组血清sST2、BNP水平均明显高于对照组(P<0.05),且sST2、BNP 水平随心功能分级的增加而升高(P<0.05).Spearman相关性分析结果显示,HFrEF患者心功能分级与血清sST2、BNP水平均呈正相关(P<0.001).入院时、出院时、随访 1 个月、随访 3 个月、随访6 个月,预后良好组与预后不良组血清sST2、BNP水平逐渐降低(P<0.05),预后不良组血清sST2、BNP水平均高于同时间预后良好组(P<0.05).ROC曲线结果显示,血清sST2、BNP联合预测价值高于其单独指标预测价值(P<0.05).结论 血清sST2、BNP水平与HFrEF患者心功能分级相关,两者联合监测对HFrEF患者的预后具有较高的预测价值.
Aim To explore the dynamic changes of serum soluble suppression of tumorigenicity 2(sST2)and brain natri-uretic peptide(BNP)levels and their predictive value on prognosis in heart failure patients with reduced ejection fraction(HFrEF).Methods Totally 80 patients with HFrEF were selected as the HFrEF group and were further divided into the grade Ⅱ heart function group(n=27),grade Ⅲ heart function group(n=26),and grade Ⅳ heart function group(n=27)based on their heart function clas-sification upon admission.Additionally,35 healthy individuals undergoing physical examinations were selected as the control group.The HFrEF group was further divided into the good prognosis group(66 cases)and the poor prognosis group(14 cases)based on the follow-up results.General data of the HFrEF group and the control group were compared.Serum sST2 and BNP levels in the grade Ⅱ heart function group,grade Ⅲ heart function group,grade Ⅳ heart function group,and the control group were compared.Serum sST2 and BNP levels at different points in the good prognosis group and the poor prognosis group were compared.Spearman correla-tion analysis was used to analyze the relationship between heart function classification and serum sST2 and BNP levels in HFrEF pa-tients.ROC curve analysis was used to analyze the predictive value of serum sST2 and BNP levels for the prognosis of HFrEF pa-tients.Results The proportion of patients with HFrEF combined with hypertension and diabetes were higher than those of the con-trol group(P<0.05),while LVEF was lower than that of the control group(P<0.05).The levels of serum sST2 and BNP in differ-ent heart function classification groups were significantly higher than those in the control group(P<0.05),and the levels of sST2 and BNP were increased with the increase of heart function classification(P<0.05).The results of Spearman correlation analysis showed that the heart function classification of HFrEF patients was positively correlated with the levels of serum sST2 and BNP(P<0.001).At admission,discharge,1-month follow-up,3-month follow-up,and 6-month follow-up,the levels of serum sST2 and BNP in the good prognosis group and the poor prognosis group showed a decreasing trend(P<0.05),and the levels of sST2 and BNP in the poor prognosis group were higher than those in the good prognosis group at the same time(P<0.05).The results of ROC curve showed that the combined predictive value of serum sST2 and BNP was higher than that of individual indicators(P<0.05).Conclusion The levels of serum sST2 and BNP are correlated with the cardiac function grading of HFrEF patients,and their combined monitoring has high predictive value for the prognosis of HFrEF patients.
戴禛;孟玙璠;戴果福
溧阳市人民医院 心内科,苏 常州 213300溧阳市人民医院妇产科,江苏 常州 213300溧阳市南渡镇中心卫生院,江苏 常州 213300
医药卫生
HFrEF可溶性ST2BNP心功能分级预后
HFrEFsoluble ST2BNPclassification of cardiac functionprognosis
《中南医学科学杂志》 2026 (1)
44-47,4
国家自然科学基金资助项目(81904256)
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