老年慢性心力衰竭患者血清FSTL1、IL-11表达的临床意义及对预后的影响OACSTPCD
Clinical Significance of Serum FSTL1 and IL-11 Expression in Elderly Patients with Chronic Heart Failure and its Influence on Prognosis
目的 探讨老年慢性心力衰竭(CHF)患者血清卵泡抑素样蛋白 1(FSTL1)、白细胞介素(IL)-11 表达的临床意义及对预后的影响.方法 前瞻性选取2019 年6 月至2022 年6 月我院137 例老年CHF患者作为研究对象.入院时记录患者基线资料,测定并记录患者心功能指标[左室舒张末期内径(LVEDd)、左室射血分数(LVEF)]和血清FSTL1、炎症指标(IL-11、IL-1β)、心肌损伤标志物[心肌肌钙蛋白I(cTnI)、N末端B型利钠肽原(NT-pro BNP)]水平等,实施治疗.随访6 个月,观察患者预后结局.根据随访6 个月内主要不良心脏事件(MACE)评估预后,比较不同预后患者基线资料、心功能相关指标及血清指标,重点分析CHF患者血清FSTL1、IL-11 表达的临床意义及对预后的影响.结果 治疗完成后经6 个月随访,137 例老年CHF患者中有22 例发生MACE,其中15 例恶性心律失常,7 例心力衰竭,不良预后患者占16.06%.单因素分析显示,预后不良组患者 LVEF、FSTL1 低于预后良好组,LVEDd、中性粒细胞/淋巴细胞比值(NLR)、IL-11、IL-1β、cTnI、NT-Pro BNP高于预后良好组(P<0.05).经多因素Logistic回归分析显示,血清FSTL1、IL-11均是老年CHF患者预后的独立影响因素(P<0.05).绘制ROC曲线图,结果显示,入院时血清FSTL1、IL-11 单独及联合预测老年CHF患者预后不良的AUC分别为0.858、0.861、0.874,均有一定评估价值.经Spearman相关性分析检验,老年CHF患者血清FSTL1 与IL-11 水平呈负相关(r=-0.217,P=0.011).结论 血清FSTL1 高表达降低老年CHF患者预后不良风险,IL-11 高表达增加老年CHF患者预后不良风险,入院时血清FSTL1、IL-11 可用于预测老年CHF患者预后不良.
Objective To investigate the clinical significance of serum follistatin-like protein 1(FSTL1)and interleu-kin-11(IL-11)expression in elderly patients with chronic heart failure(CHF)and its influence on prognosis.Methods 137 elderly patients with CHF in our hospital from June 2019 to June 2022 were prospectively selected as the research subjects.Baseline data of patients were recorded at admission,the indexes of cardiac function[left ventricular end diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF)],serum FSTL1,blood inflammatory indexes(IL-11,IL-1β)and myocardial injury markers[cardiac troponin I(cTnI),N-terminal pro-B-type natriuretic peptide(NT-pro BNP)]levels of patients were measured and recorded,treatment was performed.After 6 months of follow-up,the prognosis of patients was observed,the prognosis was evaluated according to the major adverse cardiac events(MACE)within 6 months of follow-up.Baseline data,cardiac function related indexes and serum indexes of patients with different prognosis were compared,the clinical significance of serum FSTL1 and IL-11 expression in elderly patients with CHF and its influence on prognosis were mainly analyzed.Results After the statistics of 6-month follow-up after the end of treat-ment,of 137 elderly patients with CHF in this study,22 developed MACE,of which 15 cases had malignant arrhythmia,7 cases had heart failure,the poor prognosis of patients accounted for 16.06%.Univariate analysis showed that LVEF and FSTL1 in the poor prog-nosis group were lower than those in the good prognosis group,while LVEDd,neutrophil/lymphocyte ratio(NLR),IL-11,IL-1β,cTnI and NT-Pro BNP were higher than those in the good prognosis group(P<0.05).Through multivariate Logistic regression analysis,the results showed that serum FSTL1 and IL-11 were independent prognostic factors for elderly CHF patients(P<0.05).The ROC curve was drawn,and the results showed that the AUC of serum FSTL1 and IL-11 at admission alone and in combination in predicting the poor prognosis in elderly patients with CHF were 0.858,0.861 and 0.874,respectively,which had certain predictive value.Spearman correlation analysis test showed that serum FSTL1 and IL-11 levels were negatively correlated in elderly patients with CHF(r=-0.217,P=0.011).Conclusion High expression of serum FSTL1 can reduce the risk of poor prognosis in elderly patients with CHF,high expression of IL-11 increases the risk of poor prognosis in elderly patients with CHF,serum FSTL1 and IL-11 at admission can be used to predict the poor prognosis of elderly patients with CHF.
裴蕊慧;向宗兴
宝鸡市中医院重症医学科,陕西 宝鸡 721000
临床医学
慢性心力衰竭卵泡抑素样蛋白1白细胞介素-11
chronic heart failurefollistatin-like protein 1interleukin-11
《四川医学》 2024 (006)
618-623 / 6
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