疑难病杂志2026，Vol.25Issue(8)：918-922,5.DOI:10.3969/j.issn.1671-6450.2026.08.005
心脏Tei指数、血清ROCK1、Fibulin-5联合对先天性心脏病患者并发肺动脉高压的诊断价值
The diagnostic value of the combination of cardiac Tei index,serum ROCK1,and Fibulin-5 for complicated pulmo-nary arterial hypertension in patients with congenital heart disease
摘要
Abstract
Objective To explore the diagnostic value of the combination of cardiac Tei index,serum Rho-associated coiled-coil kinase 1(ROCK1),and Fibulin-5 for complicated pulmonary arterial hypertension(PAH)in patients with congenital heart disease(CHD).Methods A total of 90 patients with CHD-PAH who were admitted to Beijing Anzhen Hospital,Capital Medical University from April 2023 to April 2025 were selected as the CHD-PAH group and 90 CHD pa-tients with simple CHD were selected as the CHD group.Serum levels of ROCK1 and Fibulin-5 were detected by ELISA.Logistic regression analysis was used to analyze the influencing factors of CHD-PAH.The diagnostic value of cardiac Tei in-dex,serum ROCK1,and Fibulin-5 for CHD-PAH was analyzed by ROC curve.Internal validation was conducted using the Bootstrap method(1000 repeated samplings).Results Compared with the CHD group,the proportion of NYHA class Ⅲ-Ⅳ,Tei index,and serum levels of ROCK1 and Fibulin-5 were significantly higher in the CHD-PAH group(χ2/t=28.357,7.488,7.925,7.634,all P<0.001).High NYHA class[OR(95%CI)=2.950(1.382-6.299)],high Tei index[OR(95%CI)=3.284(1.389-7.764)],high serum ROCK1 level[OR(95%CI)=3.975(1.518-10.406)],and high Fibulin-5 level[OR(95%CI)=2.536(1.360-4.730)]were independent risk factors for the occurrence ofCHD-PAH.T he AUCs of cardiac Tei index,serum ROCK1,Fibulin-5 alone,and their combination for diagnosing CHD-PAH were 0.781,0.800,0.790,and 0.908,respec-tively.The combined diagnosis was significantly superior to each individual index(DeLong method:Z combination-Tei index=3.947,Z combination-ROCK1=3.812,Z combination-Fibulin-5=3.730,all P<0.001).The cutoff values for cardiac Tei in-dex,serum ROCK1,and Fibulin-5 were 0.56,21.73 ng/mL,and 3.94 ng/mL,respectively.Moreover,the Hosmer-Lemeshow test indicated a good model fit(χ2=6.064,df=8,P=0.640),confirming good consistency between the predicted probability and the measured results.Conclusion Cardiac Tei index,serum ROCK1,and Fibulin-5 levels are elevated in patients with CHD-PAH.The combination of these three parameters has high diagnostic efficacy for CHD-PAH.关键词
先天性心脏病/肺动脉高压/心脏Tei指数/血清Rho相关卷曲螺旋蛋白激酶1/衰老关键蛋白抗原-5/诊断Key words
Congenital heart disease/Pulmonary arterial hypertension/Tei index/Rho-associated coiled-coil kinase 1/Fibulin-5/Diagnosis分类
医药卫生引用本文复制引用
徐冠一,陈凌霄,陈丽,王霄芳..心脏Tei指数、血清ROCK1、Fibulin-5联合对先天性心脏病患者并发肺动脉高压的诊断价值[J].疑难病杂志,2026,25(8):918-922,5.基金项目
2021年度"扬帆"计划临床技术创新项目(2021283)2021 "Yangfan" Plan Clinical Technology Innovation Project(2021283) （2021283）
