山东医药2017，Vol.57Issue(36)：17-20,4.DOI:10.3969/j.issn.1002-266X.2017.36.005
血清TIMP-4水平在老年慢性心力衰竭早期诊断及预后评估中的价值
Clinical value of serum TIMP-4 in early diagnosis and prognosis of elderly patients with chronic heart failure
摘要
Abstract
To explore the value of tissue inhibitor of metalloproteinase-4 (TIMP-4) in the early diagnosis and prognosis of elderly patients with chronic heart failure (CHF).Methods A total of 160 cases of elderly CHF patients (CHF group) including 68 cases of mild heart failure and 92 cases of severe heart failure were selected,meanwhile,another 40 health elderly people were selected as the control group.The left ventrieular end diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) in the two groups were detected,the venous blood was extracted to determine the serum levels of TIMP-4 by double antibody sandwich enzyme-linked immunosorbent assay (ELISA).The early diagnosis value of serum TIMP-4 for CHF were analyzed by ROC curve.At 3,6,and 9 months after discharge,we reviewed the heart color Doppler ultrasound of elderly CHF patients and did the statistics of their heart events.Results The LVEDD in the CHF group was significantly higher than that of the control group,whereas LVEF and TIMP-4 were significantly lower than those of the control group,especially in the severe heart failure patients (all P ＜ 0.05);correlation analysis showed that the serum TIMP-4 level was positively correlated with LVEF (r =0.816,P ＜ 0.05),and was negatively correlated with LVEDD (r =-0.266,P ＜ 0.05).ROC curve analysis showed that the area under the curve (AUC) of serum TIMP-4 in diagnosis of elderly CHF patients was 0.916 (95％ CI:0.869-0.951) with the sensitivity of 77.0％ and the specificity of 92.0％.The cut-off value was 1.41 ng/mL.According to the cut-off value,we divided the elderly CHF patients in the high level TIMP-4 group (TIMP-4 ＞ 1.41 ng/mL,n =46) and low level TIMP-4 group (TIMP-4≤1.41 ng/mL,n =114).The 3-month cardiac event-free survival between the high level TIMP-4 group and low level TIMP-4 group was not significant different (P ＞ 0.05).The 6-month and 9-month cardiac event-free survival in the high level TIMP-4 group was significantly higher than that in the low level TIMP-4 group,and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusion Serum TIMP-4 can be used as a predictor for the early diagnosis and prognosis of elderly patients with CHF.关键词
慢性心力衰竭/组织型金属蛋白酶抑制剂4/老年人/诊断/预后Key words
chronic heart failure/tissue inhibitor of metalloproteinase 4/elderly patients/diagnosis/prognosis分类
医药卫生引用本文复制引用
黄奕君,郑茵,李伟,高照,卢少泉,李云倩..血清TIMP-4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].山东医药,2017,57(36):17-20,4.基金项目
海南省卫生计生行业科研项目(16A200111) （16A200111）
