老年慢性心力衰竭患者血浆Sesn2、HGF与心功能的相关性及其预测价值

The correlation of plasma Sesn2 and HGF with cardiac function in elderly patients with chronic heart failure and their predictive value

摘要:

目的 探讨血浆Sesn2、肝细胞生长因子（HGF）与老年慢性心力衰竭（CHF）患者心功能的关系及其对CHF的预测价值。方法 选取2016年4月—2019年5月于北京市第二医院收治的CHF患者150例，依据NYHA心功能分级标准分为Ⅱ级组、Ⅲ级组及Ⅳ级组；另选择同期该院健康体检者50例作为对照组。比较各组血浆HGF、Sesn2、N末端脑钠肽前体（NT-proBNP）水平、左心室质量指数（LVMI）和超声心动图指标，分析CHF患者血浆HGF、Sesn2与NT-proBNP、LVMI及超声心动图指标的相关性。结果 Ⅳ级组血浆HGF、Sesn2、NT-proBNP及LVMI较Ⅲ级组高，LVEDD较Ⅲ级组厚，LVEF较Ⅲ级组低（P <0.05）；Ⅲ级组血浆HGF、Sesn2、NT-proBNP水平及LVMI较Ⅱ级组高，LVEDD较Ⅱ级组厚，LVEF较Ⅱ级组低（P <0.05）；Ⅱ级组血浆HGF、Sesn2、NT-proBNP水平及LVMI较对照组高，LVEDD较对照组厚，LVEF较对照组低（P <0.05）。CHF患者血浆HGF、Sesn2与NT-proBNP、LVEDD及LVMI呈正相关（P <0.05），与LVEF呈负相关（P <0.05）。Sesn2预测CHF的截断值为15.16 ng/ml，敏感性为85.6%（95% CI：0.746，0.913），特异性为70.9%（95% CI：0.681，0.806）；HGF预测CHF的截断值为204.61 ng/ml，敏感性为54.9%（95% CI：0.433，0.672），特异性为68.8%（95% CI：0.534，0.771）。结论 老年CHF患者血浆HGF、Sesn2水平异常升高，且与NT-proBNP、LVEDD及LVMI呈正相关，对老年CHF具有较好的预测价值。

Abstract:

Objective To investigate the correlation of plasma sestrin 2 (Sesn2) and hepatocyte growth factor (HGF) with cardiac function in elderly patients with chronic heart failure (CHF) and their predictive value for CHF.Methods A total of 150 CHF patients who were admitted to The Second Hospital of Beijing from April 2016 to May 2019 were selected, and they were divided into grade II group (n = 46), grade III group (n = 62), and grade IV group (n =42) according to the New York Heart Association (NYHA) classification. Another 50 healthy people who underwent physical examination in The Second Hospital of Beijing during the same period were selected as control group. The plasma levels of HGF, Sesn2, N-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular mass index (LVMI) and echocardiographic parameters were compared among the groups. The correlation of plasma HGF and Sesn2 with NT-proBNP, LVMI and echocardiographic parameters in CHF patients was analyzed.Results The plasma levels of HGF and Sesn2, NT-proBNP, left ventricular end-diastolic dimension (LVEDD) and LVMI in grade IV group were higher than those in grade III group (P < 0.05), whereas LVEF in grade IV group was lower than that in grade III group (P < 0.05). The similar trends were observed in the comparisons between grade III group and grade II group (P < 0.05), as well as between grade II group and control group (P < 0.05). In CHF patients, plasma HGF and Sesn2 positively correlated with NT-proBNP, LVEDD and LVMI (P < 0.05), but negatively correlated with LVEF (P < 0.05). The cut-off value of Sesn2 for predicting CHF was 15.16 ng/ml, with a sensitivity of 0.856 (95% CI: 0.746, 0.913) and a specificity of 0.709 (95% CI: 0.681, 0.806); the cut-off value of HGF for predicting CHF was 204.61 ng/ml, with a sensitivity of 0.549 (95% CI: 0.433, 0.672) and a specificity of 0.688 (95% CI: 0.534, 0.771).Conclusions The plasma levels of HGF and Sesn2 are abnormally elevated in elderly patients with CHF, and are strongly correlated with NT-proBNP, LVEDD and LVMI, with a great predictive value for CHF in the elderly.