老年慢性心力衰竭患者血清 SCD-1 和 sVEGFR-2 表达水平 及其与预后的评估价值研究. (Chinese)

Objective To investigate the prognostic value of serum syndecan-1 (SCD-1) and soluble vascular endothelial growth factor receptor -2 (sVEGFR-2) in elderly patients with chronic heart failure (CHF). Methods 175 elderly CHF patients admitted to Beijing Fengtai Integrated Traditional Chinese and Western Medicine Hospital from March 2018 to October 2021 were selected. Serum SCD-1 and sVEGFR-2 levels were detected and performed after discharge. Multivariate Logistic regression analysis was used to analyze the risk factors of poor prognosis in elderly patients with CHF. Receiver operating characteristic curve (ROC) was used to analyze the value of SDC-1 and sVEGFR-2 in predicting poor prognosis in elderly patients with CHF. Results Two of 177 elderly CHF patients were lost during the follow-up period, and 175 were included in the final analysis. The serum SCD-1 (6.95±1.87 ng/ml ) and sVEGFR-2 (2.75±0.46 μg/L) levels were higher than those in the good prognosis group（4.21±0.63 ng/ml，1.02±0.35 μg/L), and the differences were statistically significant(t=14.454, 24.465, all P< 0.05). The results of multivariate Logistic regression analysis showed that NYHA grade Ⅳ, high level of B-type brain natriuretic peptide, high level of SCD-1 and high level of sVEGFR-2 were risk factors for poor prognosis in elderly patients with CHF （Waldχ 2 =8.827, 10.856, 7.594, 8.627，all P ＜ 0.01）. The area under the curve of SCD-1 and sVEGFR-2 in predicting the prognosis of elderly CHF patients was 0.700(95%CI：0.626 ～ 0.766) and 0.761(95%CI：0.691 ～ 0.822), which had no significant difference compared with BNP [0.804(95%CI：0.737 ～ 0.860)], the difference was statistically significant （z=1.769,1.123，all P ＞ 0.05）. The area under the curve of combined SCD-1, sVEGFR-2 and BNP in predicting the prognosis of elderly CHF patients was 0.943(95%CI：0.898 ～ 0.973). It was higher than SCD-1, sVEGFR-2 and BNP alone （z=4.586, 3.851, 3.094, all P ＜ 0.05）.Conclusion Serum levels of SCD-1 and sVEGFR2 are significantly increased in elderly patients with poor prognosis of CHF, which were related to poor prognosis of elderly CHF patients, and can be used as potential markers for prognosis analysis of elderly CHF patients. [ABSTRACT FROM AUTHOR]

目的　探讨血清多配体蛋白聚糖 -1（serum syndecan-1, SCD-1）和可溶性血管内皮生长因子受体 -2（soluble vascular endothelial growth factor receptor -2, sVEGFR-2）对老年慢性心力衰竭（chronic heart failure, CHF）患者预后 的预测价值。方法　选择 2018 年 3 月～ 2021 年 10 月北京市丰台中西医结合医院心内科住院部收治的 175 例老年 CHF 患者, 检测血清 SCD-1 和 sVEGFR-2 水平, 出院后随访和统计因心力衰竭再次住院和心源性死亡发生情况。多因素 Logistic 回归分析老年 CHF 患者预后不良的危险因素。受试者工作特征曲线（ROC）分析 SDC-1 和 sVEGFR-2 预测老 年 CHF 患者预后不良的价值。结果 177 例老年 CHF 患者随访期间失访 2 例, 最终 175 例纳入结果分析。预后不良组 血清 SCD-1（6.95±1.87 ng/ml）和 sVEGFR-2（2.75±0.46 μg/L）水平高于预后良好组（4.21±0.63 ng/ml, 1.02±0.35 μg/L), 差异均有统计学意义（t=14.454, 24.465, 均 P ＜ 0.05）。多因素 Logistic 回归分析结果显示 NYHA Ⅳ级、高 水平 B 型脑钠肽、高水平 SCD-1, 高水平 sVEGFR-2 是老年 CHF 患者预后不良的危险因素（Wald χ² =8.827, 10.856, 7.594, 8.627, 均 P ＜ 0.01）。SCD-1 和 sVEGFR-2 预测老年 CHF 患者预后的曲线下面积为 0.700（95%CI：0.626 ～ 0.766）和 0.761 （95%CI：0.691 ～ 0.822), 与 BNP［0.804（95%CI：0.737 ～ 0.860)］比较, 差异均无统计学意义（z=1.769, 1.123, 均 P ＞ 0.05）；联合 SCD-1, sVEGFR-2 和 BNP 预测老年 CHF 患者预后的曲线下面积为 0.943（95%CI：0.898 ～ 0.973), 高于单独 SCD-1, sVEGFR-2 和 BNP（z=4.586, 3.851, 3.094, 均 P ＜ 0.05). 结论　老年 CHF 预后不良患者血清 SCD-1 和 sVEGFR2 水平均显著增高, 且与老年 CHF 患者预后不良有关, 可作为老年 CHF 患者预后分析的潜在标志物。 [ABSTRACT FROM AUTHOR]

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