文章摘要
血清sST2结合左心室射血分数对急性心肌梗死后心力衰竭的预测价值
Predictive value of serum sST2 combined with left ventricular ejection fraction in patients with heart failure after acute myocardial infarction
投稿时间：2018-07-02  
DOI：10.3969/j.issn.1000-0399.2019.04.008
中文关键词: 可溶性生长刺激表达基因2蛋白  左心室射血分数  急性心肌梗死  心力衰竭
英文关键词: Soluble growth stimulation expressed gene 2  Left ventricular ejection fraction  Acute myocardial infarction  Heart failure
基金项目:2018年度河南省医学科技公关计划项目（项目编号：2018020314）；河南省教育厅课题项目（项目编号：13A320083）；开封市科技计划项目（项目编号：1603087）
作者单位E-mail
王国良 475000 河南开封 河南大学第一附属医院心血管内科  
马光 475000 河南开封 河南大学第一附属医院心血管内科  
滕伟 475000 河南开封 河南大学第一附属医院心血管内科  
翟小菊 475000 河南开封 河南大学第一附属医院心血管内科  
惠学志 475000 河南开封 河南大学第一附属医院心血管内科 huixz9072@126.com 
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中文摘要:
      目的 探讨可溶性生长刺激表达基因2蛋白（sST2）结合左心室射血分数（LVEF）对急性心肌梗死（AMI）后心力衰竭（HF）的预测价值。方法 选取2016年4月至2017年4月河南大学第一附属医院收治的128例初发AMI患者为研究对象，测定其入院时LVEF和血清sST2水平，并随访12个月，根据是否发生HF分为HF组（23例）和非HF组（105例），比较两组患者性别、年龄、糖尿病史、高血压史、体质指数、心率、吸烟史、治疗方法、用药情况、血常规、病变支数、LVEF和血清sST2水平等，并分析影响AMI后HF的危险因素及LVEF、sST2联合检测对AMI后HF的预测价值。结果 HF组病变支数、N末端脑钠肽前体（NT-proBNP）、sST2水平均高于非HF组，LVEF低于非HF组（P<0.05）；多因素logistic回归分析显示，病变支数、NT-proBNP、sST2、LVEF是AMI后发生HF的独立预测因素（P<0.05）；sST2联合LVEF预测AMI后HF的敏感度、特异度、曲线下面积（AUC）均高于sST2、LVEF单独检测；sST2以45 pg/mL为临界值，sST2 ≥ 45 pg/mL组HF发生的风险大于sST2<45 pg/mL组（P<0.05）；LVEF以50%为临界值，LVEF ≥ 50%组HF发生的风险大于LVEF<50%组（P<0.05）。结论 HF患者血清sST2水平明显升高，可能是AMI后发生HF的独立预测因素，结合LVEF检查可提高对AMI后发生HF的预测价值。
英文摘要:
      Objective To explore the predictive value of soluble growth stimulation expressed gene2 (sST2) combined with left ventricular ejection fraction (LVEF) in patients with heart failure (HF) after acute myocardial infarction (AMI). Methods A total of 128 patients with initial AMI admitted to the First Affiliated Hospital of Henan University from April 2016 to April 2017 were selected for the study. The levels of LVEF and serum sST2 were measured at admission, and the patients were followed up for 12 months. According to the occurrence of HF, the patients were divided into HF group (23 cases) and non-HF group (105 cases). The gender, age, history of diabetes, history of hypertension, body mass index, heart rate, history of smoking, treatment methods, medication, blood routine, number of stenosed coronary vessel and levels of LVEF and serum sST2 were compared between the two groups, and the risk factors that affected HF after AMI and the predictive value of LVEF combined with sST2 on HF after AMI were analyzed. Results The number of stenosed coronary vessel, N-terminal pro-brain natriuretic peptide (NT-proBNP) and sST2 in HF group was significantly larger than that in non-HF group while LVEF was lower than that in non-HF group (P<0.05). Multivariate Logistic regression analysis showed that number of stenosed coronary vessel, NT-proBNP, sST2 and LVEF were independent predictors for HF after AMI (P<0.05). The sensitivity, specificity and area under the curve (AUC) of sST2 combined with LVEF in predicting HF after AMI were higher than those of single sST2 or LVEF detection. 45pg/mL of sST2 was taken as the critical value, and the risk of HF in sST2 ≥ 45pg/mL group was greater than that in sST2<45pg/ML group (P<0.05); 50% of LVEF was taken as the critical value, and the risk of HF in LVEF ≥ 50% group was greater than that in LVEF<50% group (P<0.05). Conclusion Serum sST2 level in patients with heart failure is significantly elevated, and it may be an independent predictor for HF after AMI. sST2 combined with LVEF can improve the predictive value of HF after AMI.
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