血清Lp-PLA2、sST2及NT-proBNP评估缺血性心肌病合并心力衰竭患者心功能及短期预后的预测价值OA
Assessment of Cardiac Function and Predictive Value for Short-Term Prognosis by Serum Lp-PLA2,sST2 and NT-proBNP in Elderly Patients with Ischemic Cardiomyopathy Complicated with Heart Failure
目的:分析血清Lp-PLA2、sST2及NT-proBNP对老年缺血性心肌病合并心力衰竭患者心功能评估及预测短期不良预后的价值.方法:选取2022年1月～2023年12月江苏省荣军医院收治的老年缺血性心肌病合并心力衰竭患者95例(研究组)临床资料进行回顾性研究,另选取我院老年体检者90名作为对照组.研究组根据心功能评定分级分为心功能Ⅱ～Ⅲ级组、心功能Ⅳ级组;研究组根据预后情况分为预后良好组、预后不良组;将不同组血清Lp-PLA2、sST2 及NT-proBNP水平进行对比,分析血清Lp-PLA2、sST2 及NT-proBNP水平对缺血性心肌病合并心力衰竭患者心功能评定的影响,以及对短期预后的预测价值.结果:95例患者中,按NYHA分级心功能Ⅱ～Ⅲ级58例(61.05%),心功能Ⅳ级37例(38.95%);预后不良组64例(67.37%),预后良好组31例(32.63%).心功能Ⅱ～Ⅲ级患者血清Lp-PLA2、sST2、NT-proBNP水平显著低于心功能Ⅳ级患者,预后良好组的血清Lp-PLA2、sST2及NT-proBNP水平显著低于预后不良组(P<0.05).ROC曲线分析结果显示,血清Lp-PLA2、sST2及NT-proBNP水平联合预测老年缺血性心肌病合并心力衰竭短期预后的曲线下面积(AUC=0.937)均高于单独预测(AUC分别为0.900、0.773、0.922).结论:血清Lp-PLA2、sST2及NT-proBNP水平三者联合检测可能对老年缺血性心肌病合并心力衰竭患者预后具有较好的预测价值,但仍需大样本前瞻性研究验证.
Objective:To analyze the value of serum lipoprotein-associated phospholipase A2(Lp-PLA2),soluble growth-stimulating gene 2 protein(sST2)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in evaluating cardiac function and predicting short-term adverse prognosis in elderly patients with ischemic cardiomyopathy complicated with heart failure.Methods:A retrospective study was conducted on the clinical data of 95 elderly patients with ischemic cardiomyopathy complicated with heart failure(study group)admitted to Jiangsu Rongjun Hospital from January 2022 to December 2023.In addition,90 elderly physical examinees in our hospital were selected as the control group.The study group was divided into NYHA gradeⅡ～Ⅲgroup and NYHA grade Ⅳ group according to cardiac function classification,and into good prognosis group and poor prognosis group according to prognosis.The serum levels of Lp-PLA2,sST2 and NT-proBNP were compared among different groups to analyze the effects of these serum indicators on cardiac function evaluation and their predictive value for short-term prognosis in patients with ischemic cardiomyopathy complicated with heart failure.Results:Among the 95 patients,58 cases(61.05%)were NYHA gradeⅡ～Ⅲ,37 cases(38.95%)were NYHA gradeⅣ;64 cases(67.37%)were in the poor prognosis group,and 31 cases(32.63%)were in the good prognosis group.The serum levels of Lp-PLA2,sST2 and NT-proBNP in patients with NYHA grade Ⅱ～Ⅲ were significantly lower than those in patients with NYHA grade Ⅳ,and the serum levels of Lp-PLA2,sST2 and NT-proBNP in the good prognosis group were significantly lower than those in the poor prognosis group(all P<0.05).ROC curve analysis showed that the area under the curve(AUC=0.937)of combined detection of serum Lp-PLA2,sST2 and NT-proBNP in predicting short-term prognosis of elderly patients with ischemic cardiomyopathy complicated with heart failure was higher than that of single detection(AUC=0.900,0.773 and 0.922,respectively).Conclusion:The combined detection of serum Lp-PLA2,sST2 and NT-proBNP may have a good predictive value for the prognosis of elderly patients with ischemic cardiomyopathy complicated with heart failure,but it still needs to be verified by large-sample prospective studies.
周炜;徐慧竹;陈啸;曹艳萍
江苏省荣军医院,江苏 无锡 214000江苏省荣军医院,江苏 无锡 214000江苏省荣军医院,江苏 无锡 214000江苏省荣军医院,江苏 无锡 214000
医药卫生
缺血性心肌病心力衰竭老年人脂蛋白相关磷脂酶A2血清可溶性生长刺激表达基因2蛋白氨基末端脑钠肽前体不良预后
ischemic cardiomyopathyheart failureelderlylipoprotein-associated phospholipase A2(Lp-PLA2)serum soluble growth-stimulating gene 2 protein(sST2)N-terminal pro-brain natriuretic peptide(NT-proBNP)poor prognosis
《中医康复》 2026 (3)
39-45,7
无锡市卫生计生委科研项目计划(Q202244)
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