摘要
目的分析慢性心力衰竭(慢性心衰,CHF)患者合并早期慢性肾功能衰竭(肾衰)血清中转化生长因子-β1(TGF-β1)、单核细胞趋化蛋白-1(MCP-1)水平,探讨TGF-β1、MCP-1单独及联合对CHF合并早期肾衰的诊断价值。方法选取2019年1月至2020年10月于河南科技大学第一附属医院收治的120例CHF患者为研究对象,将其中确诊并合并早期肾衰患者63例作为CHF合并肾衰组,单一CHF患者57例作为CHF组;另取我院同期健康体检者70例为对照组。检测三组患者的血清TGF-β1、MCP-1水平、血尿素氮(BUN)、肌酐(Scr)水平、24 h尿蛋白定量(UPr),用ROC曲线分析TGF-β1、MCP-1单独及二者联合对CHF合并早期肾衰诊断价值。结果CHF合并肾衰组患者血清TGF-β1、MCP-1水平均显著高于CHF组及对照组(P<0.05),CHF组患者血清TGF-β1、MCP-1水平均显著高于对照组,差异有统计学意义(P<0.05)。CHF合并肾衰组Scr、BUN、UPr水平均显著高于CHF组及对照组(P<0.05);CHF组患者Scr、BUN、UPr水平与对照组比较,差异无统计学意义(P>0.05);血清TGF-β1、MCP-1均与Scr、BUN、UPr呈正相关(P<0.05)。TGF-β1、MCP-1诊断CHF合并早期肾衰曲线下面积分别为0.804、0.817,最佳截断值分别为35.75 pg/ml、117.65 pg/ml;TGF-β1联合MCP-1诊断CHF合并早期肾衰曲线下面积为0.910,特异度为85.70%,敏感度为81.00%。结论CHF合并早期肾衰患者血清TGF-β1、MCP-1水平显著升高,TGF-β1联合MCP-1对CHF患者合并早期肾衰具有一定诊断价值。
Objective To analyze the levels of serum transforming growth factorβ1(TGF-β1)and monocyte chemoattractant protein-1(MCP-1)in patients with chronic heart failure(CHF)complicated by early chronic renal failure(CRF),and discuss the diagnostic value of TGF-β1,MCP-1 and TGF-β1 combined with MCP-1 to CHF complicated by early CRF.Methods The patients(n=120)with CHF were chosen from the First Affiliated Hospital of Henan University of Science and Technology from Jan.2019 to Oct.2020.The patients with CHF complicated by CRF were selected into CHF+CRF group(n=63)and patients with only CHF were selected into CHF group(n=57).At the same time,healthy controls were selected into control group(n=70).The levels of serum TGF-β1,MCP-1,blood urea nitrogen(BUN),serum creatinine(Scr)and 24-hour urine protein quantification(UPr)were detected in 3 groups.The diagnostic value of TGF-β1,MCP-1 and TGF-β1 combined with MCP-1 to CHF complicated by early CRF was analyzed by using receiver operating characteristic(ROC)curve.Results The levels of TGF-β1 and MCP-1 were significantly higher in CHF+CRF group than those in CHF group and control group(P<0.05),and were significantly higher in CHF group than those in control group(P<0.05).The levels of Scr,BUN and UPr were significantly higher in CHF+CRF group than those in CHF group and control group(P<0.05),and difference in levels of Scr,BUN and UPr had no statistical significance between CHF group and control group(P>0.05).TGF-β1 and MCP-1 were positively correlated to Scr,BUN and UPr(P<0.05).In diagnosis of CHF complicated by early CRF,the area under curve(AUC)of TGF-β1 was 0.804 and optimal cutoff value was 35.75 pg/ml,and AUC of MCP-1 was 0.817 and optimal cutoff value was 117.65 pg/ml.AUC of TGF-β1 combined with MCP-1 was 0.910,specificity was 85.70%and sensitivity was 81.00%in diagnosis of CHF complicated by early CRF.Conclusion The levels of serum TGF-β1 and MCP-1 increase significantly in patients with CHF complicated by early CRF,and combination of TGF-β1 and MCP-1 has some diagnostic value to CHF complicated by early CRF.
作者
来利红
杨兰
汪晓东
陈士芳
Lai Lihong;Yang Lan;Wang Xiaodong;Chen Shifang(Department of Cardiology,First Affiliated Hospital of Henan University of Science and Technology,Zhengzhou 471000,China;不详)
出处
《中国循证心血管医学杂志》
2022年第2期194-196,201,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
河南省医学科技攻关计划联合共建项目(2018020269)。
