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心力衰竭患者血清可溶性ST2水平的测定及其诊断价值
袁伟,顾宇英,张代富
0
(同济大学附属东方医院心血管内科,上海 200120)
摘要:
目的 测定心力衰竭患者血清可溶性ST2(sST2)水平,探讨其对心力衰竭的诊断价值。方法 选取同济大学附属东方医院2009年7月至2010年12月期间于心内科住院的心力衰竭患者192例,按纽约心脏协会(NYHA)心功能标准进行分级。所有入组病例均详细询问病史,入院后完善血清超敏C反应蛋白、脑钠肽(brain natriuretic peptide,BNP)、肌钙蛋白、肌酸激酶同工酶MB以及心脏超声检查,并应用酶联免疫吸附法检测sST2水平。结果 心力衰竭患者sST2明显高于正常对照人群(P=0.003)。sST2对心力衰竭诊断的敏感性和特异性分别为88.2%和77.8%。相关分析显示,sST2与BNP(r=0.427,P=0.01)、超敏C反应蛋白(r=0.252,P=0.023)、肌钙蛋白(r=0.330,P=0.041)以及左室射血分数(r=-0.354,P=0.047)具有相关性。高水平sST2提示患者近期预后不佳。结论 sST2与BNP、左室射血分数等指标具有相关性,可用于心力衰竭的诊断,并提示近期内预后不佳。
关键词:  心力衰竭  ST2蛋白  预后  诊断
DOI:10.3724/SP.J.1008.2012.0175
投稿时间:2011-08-16修订日期:2011-10-12
基金项目:
Measurement of serum soluble ST2 in patients with heart failure and its diagnostic value
YUAN Wei,GU Yu-ying,ZHANG Dai-fu
(Department of Cardiology, Shanghai East Hospital, Tongji University, Shanghai 200120, China)
Abstract:
Objective To measure serum soluble ST2 level in patients with heart failure and to evaluate its diagnostic value for heart failure. MethodsWe selected 192 heart failure patients who were hospitalized in the Cardiology Department of East Hospital, Tongji University during Jul. 2009 to Dec. 2010. The selected patients were divided into different groups according to the classification criterion of New York Heart Association(NYHA). The serum high-sensitivity C-reactive protein, brain natriuretic peptide, cardiac troponin I (cTnI), and creatine kinase isomer-MB were all examined after admission. All the patients received cardiac ultrasound examination. The soluble ST2 levels were determined by ELISA. ResultsThe level of sST2 in heart failure patients was significantly higher than that in healthy controls(P=0.003). The diagnosis sensitivity and specificity of soluble ST2 for heat failure were 88.2% and 77.8%, respectively. Correlation analysis showed that sST2 value was correlated with B-type natriuretic peptide(r=0.427, P=0.01), high-sensitivity C-reactive protein(r=0.252, P=0.023), troponin(r=0.330, P=0.041) and left ventricular ejection fraction(r=-0.354, P=0.047). ConclusionST2 is correlated with B-type natriuretic peptide, left ventricular ejection fraction and so on, and it can be used for diagnosis of heart failure. High ST2 level indicates poor short-term prognosis of heart failure patients.
Key words:  heart failure  ST2 protein  prognosis  diagnosis