| 蔡春燕,杜雳.老年慢性心力衰竭病人血清 hs-cTnI、MMP-9、sST2水平检测及临床意义[J].安徽医药,2023,27(4):737-741. |
| 老年慢性心力衰竭病人血清 hs-cTnI、MMP-9、sST2水平检测及临床意义 |
| Detection and clinical significance of serum hs-cTnI, MMP-9, sST2 levels in elderly patients with chronic heart failure |
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| DOI：10.3969/j.issn.1009-6469.2023.04.023 |
| 中文关键词: 心力衰竭 高敏肌钙蛋白 T 基质金属蛋白酶 -9 可溶性基质溶素 -2 心功能分级 老年人 |
| 英文关键词: Heart failure hs-cTnI MMP-9 sST2 Cardiac function classification Aged |
| 基金项目:云南省高校基础研究联合专项项目( 202001BA070001-047) |
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| 中文摘要: |
| 目的探究老年慢性心力衰竭病人血清高敏肌钙蛋白 T(hs-cTnI)、基质金属蛋白酶 -9(MMP-9)、可溶性基质溶素 -2(sST2)水平检测及临床意义。方法选取解放军联勤保障部队第九二〇医院 2017年 5月至 2021年 6月收治的 100例老年慢性心力衰竭病人作为观察组，心功能分级为 Ⅱ～Ⅳ级，其中 Ⅱ级 32例， Ⅲ级 34例， Ⅳ级 34例；另选取该院同期体检的心功能正常且无心脏病的老年人 60例作为对照组。比较两组临床资料、血清 hs-cTnI、MMP-9、sST2水平，分析老年慢性心力衰竭影响因素，评价血清 hs-cTnI、MMP-9、sST2水平对老年慢性心力衰竭的诊断价值，并比较不同心功能分级病人血清 hs-cTnI、MMP-9、 sST2水平。结果两组性别、年龄、体质量指数( BMI)、血胆固醇( TC)、高密度脂蛋白胆固醇( HDL-C)、低密度脂蛋白胆固醇(LDL-C)、吸烟史、高血压及糖尿病比例比较，差异无统计学意义( P>0.05)；观察组血清脑钠肽( BNP)(535.63±60.87)ng/L水平高于对照组( 78.62±25.41)ng/L，左室射血分数( LVEF)(49.83±5.47)%低于对照组( 56.74±6.25)%，差异有统计学意义( P<0.05)；观察组血清 hs-cTnI水平( 0.59±0.24)ng/L、MMP-9水平( 452.39±35.84)ng/L、sST2水平( 62.85±24.29)μg/L高于对照组( 0.18±0.08)ng/L、(137.69±21.59)ng/L、(32.49±14.21)μg/L，差异有统计学意义( P<0.05)； logistic回归模型，结果显示，调整 BNP、LVEF等混杂因素后， hs-cTnI、MMP-9、sST2均仍与老年慢性心力衰竭病人独立相关( P<0.05)； ROC曲线，结果显示，血清 hs-cTnI、 MMP-9、sST2水平联合诊断老年慢性心力衰竭的 AUC为 0.91，较各原始因子单独诊断价值明显提高； Spearman相关性模型分析可知，老年慢性心力衰竭病人血清 hs-cTnI、MMP-9、sST2水平与心功能分级呈正相关关系( P<0.05)。结论老年慢性心力衰竭病人血清 hs-cTnI、MMP-9、sST2水平明显升高，且均与心功能分级明显相关，临床可检测其水平，明确诊断疾病，掌握病人病情程度，有助于临床治疗方案的制定。 |
| 英文摘要: |
| Objective To investigate the detection and clinical significance of serum high-sensitivity troponin T (hs-cTnI), matrix metalloproteinase-9 (MMP-9) and soluble stromelysin-2 (sST2) levels in elderly patients with chronic heart failure.Methods One hundred elderly patients with chronic heart failure admitted to the 920th Hospital of the PLA Joint Logistics and Security Forces from May2017 to June 2021 were selected as the observation group, with cardiac function graded from grade Ⅱ to Ⅳ , including 32 cases ofgrade Ⅱ, 34 cases of grade Ⅲ, and 34 cases of grade Ⅳ; another 60 cases of elderly people with normal cardiac function and no heartdisease from the same period of physical examination in the hospital were selected as the control group. We compared the clinical data,serum hs-cTnI, MMP-9 and sST2 levels between the two groups, analyzed the factors affecting chronic heart failure in the elderly, evaluated the diagnostic value of serum hs-cTnI, MMP-9 and sST2 levels on chronic heart failure in the elderly, and compared the serum hscTnI, MMP-9 and sST2 levels in patients with different cardiac function grades.Results There was no statistically significant difference between the two groups in terms of gender, age, body mass index (BMI), blood cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), smoking history, hypertension and diabetes (P>0.05); serum brain natriureticpeptide (BNP) level in the observation group (535.63±60.87) ng/L was higher than that in the control group (78.62±25.41) ng/L and leftventricular ejection fraction (LVEF) (49.83±5.47) % was lower than that of the control group (56.74±6.25) %, with statistically significant differences (P<0.05). The serum hs-cTnI level (0.59±0.24) ng/L, MMP-9 level (452.39±35.84) ng/L, and sST2 level (62.85±24.29)μg/L in the observation group were higher than those in the control group (0.18±0.08) ng/L, (137.69±21.59) ng/L, (32.49± (14.21) μg/L,with statistically significant differences (P<0.05); the result of logistic regression showed that after adjusting for the confounding factors such as BNP and LVEF, hs-cTnI, MMP-9, and sST2 were all still independently associated with elderly patients with chronic heart failure (P<0.05); the result of ROC curve showed that the AUC of serum hs-cTnI, MMP-9, and sST2 levels combined to diagnose elderlypatients with chronic heart failure was 0.91, which was significantly higher than the diagnostic value of each original factor alone;Spearman correlation model analysis showed that serum hs-cTnI, MMP-9 and sST2 levels were positively correlated with cardiac function classification in elderly patients with chronic heart failure (P<0.05).Conclusion The levels of serum hs-cTnI, MMP-9 and sST2 are significantly increased in elderly patients with chronic heart failure, and all of them are significantly correlated with the classification of cardiac function, and their levels can be detected clinically to clearly diagnose the disease, grasp the extent of the patient′s condition, and help the formulation of clinical treatment plans. |
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