外周血UCN2、CCL3水平与心律失常性心肌病合并心力衰竭患者预后的相关性分析OA
Analysis of the relationship between peripheral blood UCN2 and CCL3 levels and the prognosis of patients with arrhythmogenic cardiomyopathy complicated with heart failure
目的 探讨外周血尿皮质素 2(UCN2)、趋化因子 CC 基序配体 3(CCL3)水平与心律失常性心肌病(ACM)合并心力衰竭(HF)患者预后的关系,并分析二者对患者预后的预测价值.方法 选取 2020 年 1 月—2024 年1 月青海省西宁市第一人民医院心血管内科收治的 ACM 合并 HF 患者 118 例为 HF 组和未合并 HF 的 ACM 患者 118例为非HF 组.根据纽约心脏病协会(NYHA)分级,将HF 组患者分为Ⅱ～Ⅲ级亚组69 例和Ⅳ级亚组49 例;根据随访1 年内预后情况(失访1 例),将HF 组患者分为预后不良亚组57 例和预后良好亚组60 例.应用酶联免疫吸附试验检测外周血 UCN2、CCL3 水平;使用多因素 Logistic 回归分析 ACM 合并 HF 患者预后不良的影响因素;应用受试者工作特征(ROC)曲线分析外周血 UCN2、CCL3 水平预测 ACM 合并 HF 患者预后不良的价值.结果 HF 组外周血 UCN2、CCL3 水平高于非 HF 组(t/P=11.632/＜0.001、12.678/＜0.001);Ⅳ级亚组外周血 UCN2、CCL3 水平高于Ⅱ～Ⅲ级亚组(t/P=7.276/＜0.001、6.326/＜0.001);预后不良亚组 NYHA 分级Ⅳ级、LVEF＜30%占比及 NT-proBNP、UCN2、CCL3 水平均高于预后良好亚组(χ2/t/P=9.246/0.002、9.404/0.002、7.006/＜0.001、8.836/＜0.001、9.963/＜0.001);LVEF＜30%、UCN2 高、CCL3 高是 ACM 合并 HF 患者预后不良的独立危险因素[OR(95%CI)=2.044(1.221～3.423)、1.362(1.031～1.799)、1.115(1.005～1.237)];外周血 UCN2、CCL3 水平单独及二者联合预测 ACM 合并 HF 患者预后不良的曲线下面积(AUC)分别为 0.818、0.812、0.910,二者联合预测的 AUC 高于其各自单独预测的 AUC(Z/P=2.285/0.003、2.128/0.005).结论 ACM 合并 HF 患者外周血 UCN2、CCL3 水平升高与 HF 及不良预后密切相关,联合检测二者对患者预后具有重要的预测价值.
Objective To investigate the association of peripheral blood urocortin-2(UCN2)and chemokine CC motif ligand 3(CCL3)levels with prognosis in patients with arrhythmogenic cardiomyopathy(ACM)complicated by heart failure(HF),and to evaluate their predictive value for adverse outcomes.Methods A total of 118 patients with ACM com-plicated by HF hospitalized in the Department of Cardiovascular Medicine,Xining First People's Hospital,Qinghai Province,from January 2020 to January 2024 were enrolled as the HF group,and 118 ACM patients without HF were selected as the control group.According to baseline New York Heart Association(NYHA)classification,patients in the HF group were divi-ded into class Ⅱ-Ⅲ(n=69)and class IV(n=49)subgroups.Based on 1-year follow-up outcomes,HF patients were further divided into a poor-prognosis subgroup(n=57)and a good-prognosis subgroup(n=60).Peripheral blood UCN2 and CCL3 levels were measured at admission.Multivariate logistic regression was used to identify factors associated with poor prognosis in ACM patients with HF.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive va-lue of UCN2 and CCL3 for adverse outcomes.Results Peripheral blood UCN2 and CCL3 levels were significantly higher in the HF group than in the non-HF group(t/P=11.632/<0.001,12.678/<0.001).Patients in the NYHA class IV subgroup had significantly higher UCN2 and CCL3 levels than those in the class Ⅱ-Ⅲ subgroup(t/P=7.276/<0.001,6.326/<0.001).The poor-prognosis subgroup showed significantly higher UCN2 and CCL3 levels than the good-prognosis subgroup(t/P=8.836/<0.001,9.963/<0.001).Left ventricular ejection fraction(LVEF)<30%,elevated UCN2,and elevated CCL3 were identified as independent risk factors for poor prognosis in ACM patients with HF[OR(95%CI)=2.044(1.221-3.423),1.362(1.031-1.799),and 1.115(1.005-1.237)].The AUCs of UCN2,CCL3,and their combination for predicting poor prognosis were 0.818,0.812,and 0.910,respectively,with the combined model showing significantly superior predictive performance compared with either biomarker alone(Z=2.285,2.128;P=0.003,0.005).Conclusion Peripheral blood UCN2 and CCL3 levels are elevated in ACM patients with HF and are associated with HF progression and adverse outcomes.Combined detec-tion of UCN2 and CCL3 provides important predictive value for prognosis.
常彩莲;史岩;马延海;李宝坤;吴静
810000 青海省西宁市第一人民医院心血管内科810000 青海省西宁市第一人民医院心血管内科810000 青海省西宁市第一人民医院心血管内科810000 青海省西宁市第一人民医院心血管内科810000 青海省西宁市第一人民医院心血管内科
医药卫生
心律失常性心肌病心力衰竭尿皮质素2趋化因子CC基序配体3预后
Arrhythmogenic cardiomyopathyHeart failureUrocortin-2Chemokine CC motif ligand 3Prognosis
《疑难病杂志》 2026 (8)
906-911,6
青海省科技计划项目(2022-ZJ-729) Qinghai Provincial Science and Technology Program Project(2022-ZJ-729)
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