血清半乳糖凝集素-3和反三碘甲状腺原氨酸水平预测老年慢性心力衰竭患者预后的价值

Value of serum galectin-3 and reverse triiodothyronine levels in predicting prognosis of elderly patients with chronic heart failure

  • 摘要:
    目的  分析血清半乳糖凝集素-3(Gal-3)、反三碘甲状腺原氨酸(rT3)水平预测老年慢性心力衰竭(CHF)患者预后的价值。
    方法  选取2022年5月—2023年5月武汉科技大学附属老年病医院130例老年CHF患者为研究组, 65例老年健康体检者为对照组。比较2组血清Gal-3、rT3水平。根据随访12个月预后情况,将研究组患者分为预后不良组和预后良好组,分析入院时血清Gal-3、rT3水平对老年CHF患者预后的影响及预测预后不良的价值。
    结果  研究组血清Gal-3、rT3水平高于对照组,差异有统计学意义(P < 0.05)。研究组随访期间失访4例,完成随访患者的预后不良率为30.95%。预后不良组入院时左室射血分数(LVEF)低于预后良好组,血清Gal-3、rT3及肌酸激酶同工酶(CK-MB)、N末端脑钠肽前体(NT-proBNP)水平高于预后良好组,差异有统计学意义(P < 0.05)。入院时血清Gal-3、rT3水平升高均为老年CHF患者预后不良的独立危险因素(P < 0.05); 入院时血清Gal-3、rT3及LVEF、CK-MB、NT-proBNP预测老年CHF患者预后不良的曲线下面积(AUC)分别为0.731、0.728、0.736、0.741、0.740; Gal-3联合rT3预测的AUC为0.865, 大于Gal-3、rT3、LVEF、CK-MB、NT-proBNP单独预测的AUC(P < 0.05)。入院时血清Gal-3高水平与rT3高水平在老年CHF患者预后转归中呈次相乘模型的正向交互作用(P < 0.05)。
    结论  老年CHF患者血清Gal-3、rT3水平升高是预后不良的独立危险因素,联合检测可为临床识别预后不良高危患者提供可靠依据。

     

    Abstract:
    Objective  To analyze the prognostic value of serum galectin-3 (Gal-3) and reverse triiodothyronine (rT3) levels in predicting prognosis of elderly patients with chronic heart failure (CHF).
    Methods  A total of 130 elderly CHF patients admitted to the Geriatric Hospital Affiliated to Wuhan University of Science and Technology from May 2022 to May 2023 were enrolled as study group, and 65 elderly healthy individuals undergoing physical examination served as control group. Serum Gal-3 and rT3 levels were compared between the two groups. Based on the prognosis after a 12-month follow-up, patients in the study group were divided into poor prognosis group and good prognosis group, and the impact of serum Gal-3 and rT3 levels at admission on prognosis of elderly CHFpatients and their value in predicting poor prognosis were analyzed.
    Results  The serum Gal-3 and rT3 levels in the study group were higher than those in the control groupCM) (P < 0.05). During follow-up period, 4 patients in the study group were lost in follow-up, and the poor prognosis rate among the patients who completed the follow-up was 30.95%. At admission, the left ventricular ejection fraction (LVEF) was lower in the poor prognosis group than that in the good prognosis group, while the serum levels of Gal-3, rT3, creatine kinase isoenzyme MB (CK-MB), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were higher in the poor prognosis group (P < 0.05). Elevated serum Gal-3 and rT3 levels at admission were independent risk factors for poor prognosis in elderly CHF patients (P < 0.05). The areas under the curve(AUCs) for predicting poor prognosis in elderly CHF patients based on serum Gal-3, rT3, LVEF, CK-MB, and NT-proBNP levels at admission were 0.731, 0.728, 0.736, 0.741, and 0.740, respectively. The AUC for the combined prediction using Gal-3 and rT3 was 0.865, which was greater than the AUCs for Gal-3, rT3, LVEF, CK-MB, and NT-proBNP alone (P < 0.05). High levels of serum Gal-3 and rT3 at admission exhibited a positive sub-multiplicative interaction in predicting prognosis of elderly CHF patients (P < 0.05).
    Conclusion  Elevated serum Gal-3 and rT3 levels in elderly CHF patients are independent risk factors for poor prognosis, and combined detection can provide a reliable basis for clinically identifying high-risk patients with poor prognosis.

     

/

返回文章
返回