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中文摘要: 目的 探究慢性心力衰竭患者血清可溶性ST2(sST2)、生长分化因子-15(GDF-15)与B型利钠肽(BNP)水平变化以及在临床诊断上的价值。方法 选取2013年6月—2016年6月在上海市宝山区中西医结合医院进行就诊治疗的127例慢性心力衰竭患者（CHF组）和同期进行体检的73例健康志愿者（对照组）进行研究。检测分析两组患者sST2、GDF-15与BNP水平，就不同NYHA分级患者的sST2、GDF-15与BNP水平变化进行对比，并采用ROC曲线对血清sST2、GDF-15与BNP水平在诊断慢性心力衰竭上的临床价值进行分析。结果 CHF组的sST2、GDF-15以及BNP水平明显高于正常对照组，两组比较差异有统计学意义（P＜0.05）。不同NYHA分级的CHF患者在sST2、GDF-15以及BNP水平上存在显著差异，且随着NYHA分级的不断升高，sST2、GDF-15以及BNP水平也随之显著提高，差异比较有统计学意义（P＜0.05）。ROC曲线结果显示 BNP的ROC曲线下面积为0.849，优于和sST2和GDF-15（分别为0.683、0.768），sST2、GDF-15以及BNP在诊断CHF上的最佳cut-off值分别为16.13 ng/ml、948.69 pg/ml和873.38pg/ml，对应的敏感度和特异度分别为78.74%、80.31%和81.10%以及77.17%、78.74%和89.76%。结论 血清sST2、GDF-15以及BNP水平能够较为准确地体现慢性心力衰竭患者的病情严重程度，与其心功能状况呈现负相关，可将其作为评价和诊断慢性心力衰竭的有效指标在临床上积极推广。
Abstract:OBJECTIVE To research the changes and diagnostic value analysis of sST2, GDF-15 and BNP level in patients with chronic heart failure. METHODS 127 patients with chronic heart failure (group CHF) and 73 healthy volunteers (control group) who underwent medical treatment in our hospital from June 2013 to June ~2016 were enrolled in this study.Tthe changes of sST2, GDF-15 and BNP in patients with different NYHA grade were compared. And the ROC curve was used to analyze the clinical value of serum sST2, GDF-15 and BNP levels in the diagnosis of chronic heart failure. RESULTS The levels of sST2, GDF-15 and BNP in the CHF group were much higher than those in the normal control group, and the differences were statistically significant (P＜0.05). The levels of sST2, GDF-15 and BNP in patients with different NYHA grade were significant differences, with the increasing of NYHA classification, the levels of sST2, GDF-15 and BNP increased significantly, and the difference was statistically significant (P＜0.05). The ROC curve showed that, the area under the BNP curve of ROC was 0.849, and better than sST-2 and GDF-15 (0.683, 0.768), the optimum cut-off values of sST2, GDF-15 and BNP in the diagnosis of CHF were 16.13 ng/ml, 948.69 pg/ml, 873.38pg/ml, the corresponding sensitivity and specificity were 78.74%, 80.31%, and 81.10% 77.17%, 78.74%, 89.76%. CONCLUSION Serum sST2, GDF-15 and BNP level can accurately reflect the severity of the disease in patients with chronic heart failure, has a negative correlation with cardiac function status, which can be used as evaluation and diagnosis of chronic heart failure in clinical promotion.
keywords: chronic heart failure soluble ST2 growth differentiation factor-15 B-type natriuretic peptide
文章编号：3201803022 中图分类号：R541.6 文献标志码：
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| 作者 | 单位 |
| 关敬树① , 周 云① |
| Author Name | Affiliation |
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