【摘要】 目的通过对心力衰竭(HF)不同心功能分级的患者氨基末端脑钠肽前体(NT-proBNP)和可溶性ST2血清学水平的检测,探究其与HF诊断及预后的关系。方法选取2018年12月至2019年12月十堰市人民医院就诊的HF患者共119例作为HF组,选取同期住院的非HF患者共54例作为对照组,测量其血清可溶性ST2和NT-proBNP水平,对其进行1年随访,记录其再住院及死亡情况,并对相关结果进行统计学分析结果随着NYHA心功能分级升高,血清NT-proBNP和可溶性ST2水平逐渐升高。可溶性ST2水平有利于优化心功能分级。NT-proBNP、可溶性ST2及两者联合应用诊断HF的ROC曲线下面积分别为0.833、0.683和0.830。NT-proBNP、可溶性ST2及两者联合应用预测HF患者1年内发生不良预后的ROC曲线下面积分别为0.698、0.773和0.738。NT-proBNP、可溶性ST2及两者联合应用预测HF患者1年内死亡的ROC曲线下面积分别为0.766、0.844和0.792结论可溶性ST2对HF的诊断价值不如NT-proBNP,但在预后方面可溶性ST2显著优于NT-proBNP,是HF预后不良的独立预测因子。更多还原

【Abstract】 Objective To explore the significance of soluble ST2 and NT-proBNP levels in the diagnosis and prognosis in patients with different NYHA classification.Methods A total of 119 patients with heart failure were recruited as the heart failure group and 54 patients with non-heart failure who were hospitalized during the same period were enrolled as the control group.The serum soluble ST2 and NT-proBNP levels were measured and analyzed.Follow-up was performed to record the readmission and death within 1 year and the statistical analysis was carried out.Results As NYHA cardiac function grade increased,serum soluble ST2 and NT-proBNP levels gradually increased.The level of soluble ST2 was beneficial for optimizing heart failure classification.The areas under the ROC curve for NT-proBNP,soluble ST2 and their combined use in diagnosing heart failure were 0.833,0.683 and 0.830,respectively.The area under the ROC curve of NT-proBNP.soluble ST2 and the combination of them for predicting a poor prognosis within one year in patients with heart failure were 0.698,0.733 and 0.738,respectively.The area under the ROC curve for NT-proBNP,soluble ST2 and the combination of them for predicting death within 1 year in heart failure patients were 0.766,0.844 and 0.792,respectively.Conclusion Soluble ST2 is not as valuable as NT-proBNP in the diagnosis of heart failure,however,it is better than NT-proBNP in prognosis and is an independent predictor of poor prognosis of heart failure.更多还原