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投稿时间：2018-02-28 网络发布日期：2018-06-21
投稿时间：2018-02-28 网络发布日期：2018-06-21
中文摘要: 目的 探讨血清可溶性髓样细胞触发受体(sTREM)-1水平在老年慢性心力衰竭(CHF)早期诊断及预后评估中的价值。方法 选取2016年1月至2017年1月就诊的老年CHF患者89例(CHF组)和体检健康的老年志愿者55例(对照组)。采取双抗体夹心酶联免疫吸附法检测血清sTREM-1水平。采用超声心动图检测并计算平均室壁应力(MWS)和左心室心肌质量指数(LVMI)。比较两组血清sTREM-1水平及心功能LVMI、MWS水平。Pearson直线相关分析老年CHF患者sTREM-1水平与 LVMI、MWS水平的相关性。CHF组患者随访期失访4例，85例完成随访，出院12个月复查超声心动图,统计心脏事件的发生情况,比较出现心脏事件患者与无心脏事件患者入院时血清sTREM-1水平。采用多因素Logistic回归分析sTREM-1水平与患者心脏事件的关系。结果 与对照组比较,CHF组老年患者血清sTREM-1水平［(62.89±7.04)pg/mlvs (20.15±2.58)pg/ml］及 MWS［(912.41±92.75) mgvs (771.57±79.05) mg］和LVMI［(2.40±0.26) mg/gvs (1.71±0.21) mg/g］均明显升高,且伴随心功能NYHA分级的增加而明显升高(P<0.01)。CHF组患者血清sTREM-1水平与心功能指标MWS和LVMI分别呈正相关(r=0.651,P<0.01;r=0.681,P<0.01)。出院后第12个月出现心脏事件的老年CHF患者入院时血清sTREM-1水平明显高于无心脏事件患者［(88.75±9.15)pg/mlvs (37.03±4.14)pg/ml，P<0.01］。多因素Logistic回归分析显示,sTREM-1水平是12个月心脏事件的危险因素(OR=7.440，P<0.01)。结论 血清sTREM-1 可作为老年CHF患者早期诊断和预后判断的预测指标之一。
中文关键词: 慢性心力衰竭 可溶性髓样细胞触发受体-1 室壁应力 心肌质量指数 预后
Abstract:Objective To explore the value of serum soluble myeloid cell trigger receptor (sTREM)-1 level for early diagnosis and prognostic evaluation in elderly patients with chronic heart failure (CHF). Methods Eighty-nine elderly CHF patients (CHF group)and 55 healthy elderly volunteers (control group) from January 2016 to January 2017 were selected. Double-antibody sandwich enzyme-linked immunoassay was used to detect serum sTREM-1 level. Echocardiography was used to measure and count the mean ventricular wall stress (MWS ) and left ventricular mass index(LVMI). Serum sTREM-1 level and MWS and LVMI values were compared in two groups. Pearson linear correlation analysis was used to analyze the correlation of serum sTREM-1 level with LVMI and MWS in elderly CHF patients. In CHF group, 4 cases were missed during follow-up, and 85 cases were followed up for 12 months. Cardiac color echocardiography was re-examined, and the statistics of heart events was made 12 months after discharge. Serum sTREM-1 level at admission was compared in patients with cardiac events and without cardiac events. Multivariate Logistic regression analysis was used to analyze the relationship between sTREM-1 level and cardiac events. Results Compared with control group, serum sTREM-1 level [(62.89±7.04) pg/ml vs (20.15±2.58) pg/ml], MWS [(912.41±92.75) mg vs (771.57±79.05)mg] and LVMI [(2.40±0.26)mg/g vs (1.71±0.21)mg/g]values increased significantly in CHF group, and their levels rose all with the increase of NYHA classification(all P<0.01). Serum sTREM-1 level was positively correlated with cardiac function indexes MWS and LVMI in elderly CHF patients(P<0.01). Serum sTREM-1 level at admission in elderly CHF patients with cardiac events 12 months after discharge was significantly higher than that in patients without cardiac events [(88.75±9.15)pg/ml vs(37.03±4.14)pg/ml, P<0.01]. Multivariate logistic regression analysis showed that sTREM-1 level was a risk factor of 12-month cardiac events (OR=7.440, P<0.01). Conclusion Serum sTREM-1 level can be served as one of the predictive indexes of early diagnosis and prognostic evaluation in elderly CHF patients.
keywords: Chronic heart failure Soluble myeloid cell trigger receptor 1 Ventricular wall stress Myocardium mass index Prognosis
文章编号： 中图分类号：R 541.6 文献标志码：A
基金项目:广东省清远市科技计划项目(2015A003)
| Author Name | Affiliation |
| LI Yue-liang, Zhang Guo-qi, LI Qiao-Wen | Ward 1 of Department of Cardiovascular Medicine, Qingyuan People′s Hospital, Qingyuan, Guangdong 511518, China |
引用文本：
李月亮，张国奇，李巧汶.sTREM-1水平在老年慢性心力衰竭早期诊断及预后评估中的价值[J].中国临床研究,2018,31(6):785-788.
李月亮，张国奇，李巧汶.sTREM-1水平在老年慢性心力衰竭早期诊断及预后评估中的价值[J].中国临床研究,2018,31(6):785-788.