血管生成素样蛋白4与内脂素在急性心力衰竭患者血清中的水平及其与短期预后的关系OA
Levels of serum angiopoietin-like protein 4 and visfatin in patients with acute heart failure and their relationship with short-term prognosis
目的 探讨血管生成素样蛋白4(ANGPTL4)和内脂素在急性心力衰竭(AHF)患者血清中的水平及其与短期预后的关系.方法 选取2021年9月至2022年9月我院诊治的97例AHF患者为观察组,并纳入同期健康体检者60例为对照组.ELISA检测血清ANGPTL4和内脂素水平.于出院后对AHF患者进行3个月的随访,根据患者是否出现终点事件分为预后良好组(68例)和预后不良组(29例).比较2组患者一般资料及血清ANGPTL4、内脂素水平;采用logistic回归分析AHF预后的影响因素;应用受试者操作特征(ROC)曲线分析血清ANGPTL4和内脂素水平对AHF患者预后的评估价值.结果 与对照组比较,AHF患者血清ANGPTL4水平显著降低,内脂素水平明显升高(P<0.05).与预后良好组比较,预后不良组中肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)水平和纽约心脏协会(NYHA)分级存在统计学差异(P<0.05).与预后良好组比较,预后不良组患者血清ANGPTL4水平显著降低,内脂素水平均明显升高(P<0.05).TNF-α、IL-6、ANGPTL4、内脂素和NYHA分级是影响AHF预后的危险因素.ANGPTL4和内脂素联合预测AHF患者预后的曲线下面积(AUC)、灵敏度、特异度分别为0.932、93.10%、75.00%,高于上述指标的单独预测效能(P<0.05).结论 ANGPTL4、内脂素在AHF患者中表达异常,与患者预后关系密切;ANGPTL4、内脂素联合检测对AHF患者预后的预测价值更高.
Objective To evaluate levels in serum angiopoietin-like protein 4(ANGPTL4)and visfatin in patients with acute heart failure(AHF)and their relationship with short-term prognosis.Methods Ninety-seven patients with AHF treated at our hospital between September 2021 and September 2022 were selected as the observation group,and 60 patients who underwent health checkups during the same period were included as the control group.Serum ANGPTL4 and visfatin levels were detected using ELISA.Patients with AHF were followed up for 3 months after discharge and categorized into good(68 patients)and poor(29 patients)prognosis groups according to whether they had an endpoint event.We compared the data,including serum ANGPTL4 and visfatin levels,between the two groups and used logistic regression to analyze the factors influencing the prognosis of AHF,using receiver operating characteristic curves to determine the effects of serum ANGPTL4 and visfatin expression levels on patient prognosis.Results Serum ANGPTL4 and visfatin levels were significantly lower and higher,respectively,in patients with AHF compared with the control group(P<0.05).Significant differences were observed in the tumor necrosis factor α(TNF-α)and interleukin-6(IL-6)levels and New York heart association(NYHA)grade in the poor prognosis group compared with the good prognosis group(P<0.05).Serum ANGPTL4 levels were significantly lower,while serum visfatin levels were significantly higher in patients in the poor prognosis group compared with those in the good prognosis group(P<0.05).TNF-α,IL-6,ANGPTL4,visfatin,and NYHA classification were identified as risk factors affecting AHF prognosis.The area under the curve,sensitivity,and specificity of the combination of ANGPTL4 and visfatin in predicting the prognosis of patients with AHF were 0.932,93.10%,and 75.00%,respectively,which were higher than the predictive efficacy of the above indexes individually(P<0.05).Conclu-sion ANGPTL4 is low level in the serum of patients with AHF,and is a protective factor for their prognosis,while visfatin is high level in the serum of patients with AHF and is a prognostic risk factor.
张娟;姜静;袁平年;王洋;陈康丽
西北大学附属医院西安市第三医院 心血管内科,西安 710021西北大学附属医院西安市第三医院 重症医学科,西安 710021西北大学附属医院西安市第三医院 心血管内科,西安 710021西北大学附属医院西安市第三医院 心血管内科,西安 710021西北大学附属医院西安市第三医院 心血管内科,西安 710021
医药卫生
血管生成素样蛋白4内脂素急性心力衰竭
angiopoietin-like protein 4visfatinacute heart failure
《中国医科大学学报》 2026 (5)
411-415,5
陕西省重点研发计划(2025SF-YBXM-006)
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