| 郭清莎.基于ROC和DCA曲线分析血清ITIH4、ITGB7、LGALS3BP评估老年冠心病并发衰弱综合征的效能[J].安徽医药,待发表. |
| 基于ROC和DCA曲线分析血清ITIH4、ITGB7、LGALS3BP评估老年冠心病并发衰弱综合征的效能 |
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| 投稿时间：2026-09-07 录用日期：2026-11-07 |
| DOI： |
| 中文关键词: 冠心病 间α胰蛋白酶抑制剂重链4 整合素亚基β7 半乳糖凝集素3结合蛋白 衰弱综合征 |
| 英文关键词: |
| 基金项目:陕西省中医药管理局项目资助(2021-ZZ-LC035) |
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| 中文摘要: |
| 目的 基于受试者工作特征（ROC）曲线和决策曲线分析（DCA）评估血清间α胰蛋白酶抑制剂重链4（ITIH4）、整合素亚基β7（ITGB7）、半乳糖凝集素3结合蛋白（LGALS3BP）对老年冠心病（CHD）并发衰弱综合征（FS）的诊断效能。方法 本研究连续纳入2023年1月~2026年3月于本院确诊的137例CHD患者作为研究对象，根据FS并发情况分为N-FS组和FS组。检测所有CHD患者FS相关指标水平（握力、步速）；ELISA法检测血清ITIH4、ITGB7、LGALS3BP水平；多因素Logistic分析筛选影响CHD患者并发FS的因素；Pearson法分析血清ITIH4、ITGB7、LGALS3BP水平与FS相关指标的相关性；ROC曲线和DCA分别评估以上血清因子对CHD患者并发FS的诊断价值及以上诊断模型的临床价值。结果 与N-FS组相比，FS组肌少症、焦虑、抑郁人数占比，CCI指数，血清ITGB7、LGALS3BP水平均显著升高，血清ITIH4水平，握力，步速显著降低（P＜0.05）；Logistic回归分析显示，血清ITIH4升高是CHD患者并发FS的保护因素，而ITGB7、LGALS3BP升高及CCI指数是CHD患者并发FS的危险因素（P＜0.05）；相关性分析表明，血清ITIH4水平与握力、步速呈正相关，血清ITGB7、LGALS3BP水平与握力、步速呈负相关（P＜0.05）；ROC及DCA曲线分析显示，ITIH4、ITGB7、LGALS3BP单独诊断CHD患者并发FS的AUC分别为0.891、0.845、0.876，三者联合诊断的AUC达0.950，显著优于单独诊断（P＜0.05），且在高风险阈值0.02~0.97时，联合诊断的临床净获益率高于单独诊断。结论 CHD并发FS患者血清ITIH4水平显著降低，ITGB7、LGALS3BP水平显著升高，三者联合检测对CHD患者并发FS具有较高诊断价值。 |
| 英文摘要: |
| Purpose:AIM To evaluate the diagnostic efficiency of serum inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4), integrin beta 7 subunit (ITGB7), and lectin galactoside binding soluble 3 binding protein (LGALS3BP) for elderly patients with coronary heart disease (CHD) complicated with frail syndrome (FS) using receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Methods: In this study, 137 patients diagnosed with CHD in our hospital from January 2023 to March 2026 were consecutively included as the research subjects. They were separated into the N-FS group and the FS group based on the presence or absence of FS. The FS-related indicators (grip strength and walking speed) of all CHD patients were measured. The levels of ITIH4, ITGB7 and LGALS3BP in serum were detected by ELISA method. Multivariate Logistic analysis was used to screen the factors influencing the occurrence of FS in patients with CHD. Pearson method was used to analyze the the correlations between the levels of serum ITIH4, ITGB7, and LGALS3BP and the related indicators of FS. In addition, ROC curve and DCA were respectively employed to evaluate the diagnostic value of the above serum factors for the occurrence of FS in patients with CHD, as well as the clinical value of the above diagnostic models.Results: Compared with the N-FS group, the proportions of sarcopenia, anxiety, and depression, the CCI index, and the levels of serum ITGB7 and LGALS3BP in the FS group were significantly higher, while the level of serum ITIH4, grip strength, and walking speed were significantly lower (P < 0.05). Logistic regression analysis showed that elevated serum ITIH4 was a protective factor for FS in patients with CHD, while elevated ITGB7, LGALS3BP and CCI index were risk factors for FS in patients with CHD (P < 0.05). The correlation analysis showed that serum ITIH4 was positively correlated with grip strength and walking speed, while serum ITGB7 and LGALS3BP were negatively correlated with them (P < 0.05). ROC and DCA curve analysis showed that the AUC values for the individual diagnosis of CHD patients with FS by ITIH4, ITGB7, and LGALS3BP were 0.891, 0.845, and 0.876 respectively. The AUC value for the combined diagnosis was 0.950, which was significantly better than the individual diagnosis (P < 0.05). Moreover, when the high-risk threshold was 0.02 to 0.97, the clinical net benefit rate of the combined diagnosis was higher than that of the individual diagnosis.Conclusion: The level of serum ITIH4 in patients with CHD complicated by FSis significantly decreased, while the levels of ITGB7 and LGALS3BP are significantly elevated. Moreover, the combined detection of these three markers has a high diagnostic value for FS in patients with CHD. |
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