广西医学2024，Vol.46Issue(11)：1676-1681,6.DOI:10.11675/j.issn.0253-4304.2024.11.07
慢性肾功能衰竭合并心力衰竭患者血清ST2和NT-proBNP的水平及其临床意义
Levels of serum ST2 and NT-proBNP in patients with chronic renal failure and concomitant heart failure and their clinical significance
摘要
Abstract
Objective To explore the levels of serum growth stimulation expressed gene 2(ST2)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)in patients with chronic renal failure and concomitant heart failure and their clinical significance.Methods A total of 40 patients with chronic renal failure and concomitant heart failure(the renal failure and concomitant heart failure group),40 patients with simple heart failure(the simple heart failure group),and 40 healthy check-up individuals(the control group)were selected as the research subjects.The levels of liver function indices(ALT,AST),blood lipid indices(triglyceride,total cholesterol,LDL)levels,renal function indices(serum urea nitrogen,serum creatinine)levels,New York Heart Association(NYHA)classification of heart failure patients,and levels of serum ST2 and NT-proBNP were compared between research subjects of the three groups.The correlation of serum ST2 and NT-proBNP levels with cardiac function classification and ventricle mass index(left ventricular end diastolic dimension[LVEDD],left ventricular ejection fraction[LVEF])was analyzed.The efficiency of serum ST2 and NT-proBNP levels for diagnosing heart failure was analyzed by drawing the receiver operating characteristic curve.Results The renal failure and concomitant heart failure group exhibited a higher level of triglyceride as compared with the control group,and higher levels of serum urea nitrogen and creatinine as compared with the simple heart failure group and the control group(P＜0.05).The renal failure group and concomitant heart failure group and the simple heart failure group interpreted higher serum ST2 and NT-proBNP levels as compared with the control group(P＜0.05),and the renal failure and concomitant heart failure group yielded higher serum NT-proBNP level and LVEF as compared with the simple heart failure group(P＜0.05).Patients with NYHA classification in Ⅲ-Ⅳ of the simple heart failure group obtained higher levels of serum ST2 and NT-proBNP as compared with patients in Ⅰ-Ⅱ,while patients with NYHA classification inⅢ-Ⅳ of the renal failure and concomitant heart failure group expressed a higher serum ST2 level as compared with patients in Ⅰ-Ⅱ(P＜0.05).Serum ST2 and NT-proBNP levels positively correlated with LVEDD,whereas negatively correlated with LVEF in the simple heart failure group;furthermore,serum ST2 level positively correlated with LVEDD,whereas negatively correlated with LVEF in the renal failure and concomitant heart failure group(P＜0.05),while serum NT-proBNP level exerted no correlation with LVEDD and LVEF(P＞0.05).The results of receiver operating characteristic curve analysis revealed that in the renal failure and concomitant heart failure group and the simple heart failure group,the efficiency of serum ST2 and NT-proBNP level for diagnosing heart failure was favorable,exerting favorably high specificity and sensitivity;however,the diagnostic critical values of serum ST2 level were similar in the two groups(24.14 ng/mL and 27.59 ng/mL,respectively),whereas the diagnostic critical values of serum NT-proBNP level were great different in the two groups(1 795.00 μg/mL and 495.00 μg/mL,respectively).Conclusion Both NT-proBNP and ST2 are serological indices reflecting cardiac function,but serum ST2 level is less affected by renal function and has stronger stability.For patients with chronic renal failure and concomitant heart failure,ST2 exerts a higher diagnostic value for heart failure,and serum ST2 and NT-proBNP levels detection can be combined to obtain superior diagnostic efficiency.关键词
慢性肾功能衰竭/心力衰竭/生长刺激表达基因2蛋白/氨基末端脑钠肽前体/诊断价值Key words
Chronic renal function failure/Heart failure/Growth stimulation expressed gene 2/N-terminal pro-B-type natriuretic peptide/Diagnostic value分类
医药卫生引用本文复制引用
崔雯萱,赵海歌,王彦,梁淑新..慢性肾功能衰竭合并心力衰竭患者血清ST2和NT-proBNP的水平及其临床意义[J].广西医学,2024,46(11):1676-1681,6.基金项目
保定市科技计划自筹经费项目(2341ZF350) （2341ZF350）
河北大学附属医院/临床医学院2022年度院内基金项目(2022QC33) （2022QC33）
