可溶性生长刺激表达基因 2 蛋白在临床心力衰竭中的应用价值

兴荣 李, 晓晓 王, 娜 张, 青松 王, 贤胜 黄

摘要


目的：探讨可溶性生长刺激表达基因 2 蛋白（soluble suppression of tumorigenicity-2，sST2）对心力衰竭的诊断、评估病情严重程度的价值及其在心力衰竭不同病因中有无差异。方法：回顾性收集 2021 年 12 月至 2023 年 7 月在我院心内科因心力衰竭住院的心力衰竭患者 200 例，收集同时期入院非心力衰竭非冠心病患者 200 例作为对照组，对比分析 sST2 浓度。结果：心衰患者血清中的 sST2 浓度明显高于对照组（P ＜ 0.001）；纽约心功能分级三组 sST2 浓度存在着统计学差异 （P ＜ 0.001），不同射血分数的心力衰竭三组 sST2 浓度存在着统计学差异（P ＜ 0.001），心力衰竭不同病因中四组 sST2 浓度存在着统计学差异（P ＜ 0.001）；sST2 与 NT-proBNP 呈正相关（rs ＝ 0.681，P ＜ 0.001）、与 cTNI 浓度呈正相关（rs ＝ 0.258，P=0.004）、与左心室舒张末期内径呈正相关（rs ＝ 0.375，P ＜ 0.001）、与左房前后径呈正相关（rs ＝ 0.191，P=0.036），与 LVEF 呈负相关（rs ＝ -0.631，P ＜ 0.001）；通过 ROC 曲线分析，sST2 诊断心力衰竭的 ROC 曲线下面积为 0.896，95%可信区间（IC）为 0.864-0.929（P ＜ 0.001），与 NT-proBNP 两者联合诊断心力衰竭的 ROC 曲线下面积为 0.985，95% 可信区间（IC）为 0.974-0.997（P ＜ 0.001）。结论：心力衰竭患者 sST2 浓度明显升高，浓度越高心力衰竭越重；与射血分数、NT-proBNP、cTNI 浓度等明显相关；心力衰竭病因不同，sST2 浓度也不同。

关键词


可溶性生长刺激表达基因 2 蛋白；心力衰竭；纽约心功能分级；射血分数；扩张型心肌病；缺血性心肌病；心脏瓣

全文:

PDF

参考


Iwahana H, Yanagisawa K, Ito-Kosaka A, Kuroiwa K, Tago K, Komatsu N, Katashima R, Itakura M, Tominaga S. Different promoter usage and multiple transcription initiation sites of the interleukin-1 receptor-related human ST2 gene in UT-7 and TM12 cells. Eur J Biochem. 1999 Sep;264(2):397-406.

Pascual-Figal DA, Januzzi JL. The biology of ST2: the International ST2 Consensus Panel. Am J Cardiol. 2015 Apr 2;115(7 Suppl):3B-7B.

Aimo A, Januzzi JL Jr, Vergaro G, Richards AM, Lam CSP, Latini R, Anand IS, Cohn JN, Ueland T, Gullestad L, Aukrust P, Brunner-La Rocca HP, Bayes-Genis A, Lupón J, de Boer RA, Takeishi Y, Egstrup M, Gustafsson I, Gaggin HK, Eggers KM, Huber K, Gamble GD, Ling LH, Leong KTG, Yeo PSD, Ong HY, Jaufeerally F, Ng TP, Troughton R, Doughty RN, Passino C, Emdin M. Circulating levels and prognostic value of soluble ST2 in heart failure are less influenced by age than N-terminal pro- B-type natriuretic peptide and high-sensitivity troponin T. Eur J Heart Fail. 2020 Nov;22(11):2078-2088.

Aimo A, Januzzi JL Jr, Bayes-Genis A, Vergaro G, Sciarrone P, Passino C, Emdin M. Clinical and Prognostic Significance of sST2 in Heart Failure: JACC Review Topic of the Week. J Am Coll Cardiol. 2019 Oct 29;74(17):2193-2203.

Jin Y, Wei S, Yao L. Diagnostic performance of miR-214, BNP, NT-proBNP and soluble ST2 in acute heart failure[J]. Int J Clin Pract. 2021 Oct;75(10):e14643.

Coronado MJ, Bruno KA, Blauwet LA, Tschöpe C, Cunningham MW, Pankuweit S, van Linthout S, Jeon ES, McNamara DM, Krejčí J, Bienertová-Vašků J, Douglass EJ, Abston ED, Bucek A, Frisancho JA, Greenaway MS, Hill AR, Schultheiss HP, Cooper LT Jr, Fairweather D. Elevated Sera sST2 Is Associated With Heart Failure in Men ≤50 Years Old With Myocarditis. J Am Heart Assoc. 2019 Jan 22;8(2):e008968.

Xiang N, Liao H, Zhai Z, Gong J. Expression and significance of inflammatory reactions mediated by the IL-33/ST2 signaling pathway in the serum of heart failure patients. Am J Transl Res. 2021 Jul 15;13(7):8247-8252.

Booth RA, Hill SA, Don-Wauchope A, et al. Performance of BNP and NT-proBNP for diagnosis of heart failure in primary care patients: a systematic review[J]. Heart Fail Rev, 2014,19 (4):439- 451.

Roberts E, Ludman AJ, Dworzynski K, et al. The diagnostic accuracy of the natriuretic peptides in heart failure: systematic review and diagnostic meta-analysis in the acute care setting [J]. BMJ, 2015,350:h910

Agrawal V, Hardas S, Gujar H, Phalgune DS. Correlation of serum ST2 levels with severity of diastolic dysfunction on echocardiography and findings on cardiac MRI in patients with heart failure with preserved ejection fraction. Indian Heart J. 2022 May-Jun;74(3):229-234. doi: 10.1016/j.ihj.2022.03.001. Epub 2022 Mar 9. PMID: 35278459; PMCID: PMC9243600.

Shah RV, Chen-Tournoux AA, Picard MH, van Kimmenade RR,

Rehman SU, Mueller T, Januzzi JL Jr. Characteristics of the novel interleukin family biomarker ST2 in patients with acute heart failure. J Am Coll Cardiol.2008 Oct 28;52(18):1458-1465.

丁兵.IL-33及可溶性ST2在心力衰竭中的价值和意义[D].苏州: 苏州大学,2014.

Januzzi JL Jr, Peacock WF, Maisel AS, Chae CU, Jesse RL, Baggish AL, O'Donoghue M, Sakhuja R, Chen AA, van Kimmenade RR, Lewandrowski KB, Lloyd-Jones DM, Wu AH. Measurement of the interleukin family member ST2 in patients with acute dyspnea: results from the PRIDE (Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department) study. J Am Coll Cardiol. 2007 Aug 14;50(7):607-613.

刘金洁,李艳玲,宋占春.可溶性ST_2、TNF-α及NT-proBNP表 达水平对慢性心力衰竭患者心功能评估价值的研究[J].中国社 区医师,2021,37(18):111-112.




DOI: https://doi.org/10.12346/pmr.v5i3.8530

Refbacks

  • 当前没有refback。