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

doi:10.20223/j.cnki.1000-8535.2025.02.015

摘要/Abstract

摘要： 目的探究血清多配体蛋白聚糖-1（SCD-1）与可溶性血管内皮生长因子受体-2（sVEGFR-2）表达水平在老年慢性心力衰竭患者预后评估的判定价值。方法选取2023年1月—2024年3月珠海市第五人民医院检验科收治的110例老年慢性心力衰竭患者,检测其血清SCD-1和sVEGFR-2水平,对患者进行随访调查,了解其再次由于心力衰竭住院、心源性死亡的情况。运用多因素Logistic回归分析,探究老年慢性心力衰竭患者预后影响因素。结果 Logistic回归分析显示,心功能分级（OR=3.433,95%CI：0.934~6.431）、B型脑钠肽升高（OR=2.462,95%CI：0.861~4.765）、血清SCD-1升高（OR=3.795,95%CI：0.972~6.894）、血清sVEGFR-2升高（OR=3.842,95%CI：0.942~6.912）为影响老年慢性心力衰竭患者预后不良的重要因素（P<0.05）;联合血清SCD-1和sVEGFR-2曲线下面积0.962与B型脑肽钠曲线下面积0.844,相较于单一SCD-1曲线下面积0.658、sVEGFR-2曲线下面积0.712明显偏高（P<0.05）。结论经研究证实,老年慢性心力衰竭患者预后效果不理想,其血清SCD-1和sVEGFR-2监测水平异常升高,和老年慢性心力衰竭预后不佳存在关联性,可视为老年慢性心力衰竭患者判定预后效果的主要标志物。

关键词: 多配体蛋白聚糖-1, 可溶性血管内皮生长因子受体-2, 慢性心力衰竭, 预后评估价值

Abstract: Objective To investigate the prognostic value of serum syndecan-1（SCD-1）and soluble vascular endothelial growth factor receptor-2（sVEGFR-2）expression levels in elderly patients with chronic heart failure. Methods A total of 110 elderly patients with chronic heart failure admitted to our hospital were selected,with a time interval of January 2023 to March 2024．Serum SCD-1 and sVEGFR-2 levels were detected and follow-up investigations were conducted to understand their re hospitalization and cardiogenic death due to heart failure．Multiple logistic regression analysis was used to explore the prognostic factors affecting elderly patients with chronic heart failure. Results According to logistic retrospective analysis,heart function grading（OR=3.433,95%CI：0.934-6.431）,elevated B-type brain natriuretic peptide（OR=2.462,95%CI：0.861-4.765）,elevated serum SCD-1（OR=3.795,95%CI：0.972-6.894）,and elevated serum sVEGFR-2（OR=3.842,95%CI：0.942-6.912）were important factors affecting the poor prognosis of elderly patients with chronic heart failure,with differences P<0.05．The area under the curve of combined serum SCD-1 and sVEGFR-2 was 0.962,and the area under the curve of B-type brain peptide sodium was 0.844,which was significantly higher than that of a single SCD-1 curve of 0.658 and sVEGFR-2 curve of 0.712,with a difference of P<0.05. Conclusions Research has confirmed that the prognosis of elderly patients with chronic heart failure is not satisfied,and their serum SCD-1 and sVEGFR-2 monitoring levels are abnormally elevated,which is related to the poor prognosis of elderly patients with chronic heart failure．It can be regarded as the main biomarker for defining the prognosis of elderly patients with chronic heart failure．

Key words: syndecan-1, soluble vascular endothelial growth factor receptor-2, chronic heart failure, prognostic value

黎霏霏, 宋丹丹, 潘春荣. 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[J]. 广州医药, 2025, 56(2): 241-246.

LI Feifei, SONG Dandan, PAN Chunrong. Expression levels of serum SCD-1 and sVEGFR-2 in elderly patients with chronic heart failure and their prognostic value[J]. Guangzhou Medical Journal, 2025, 56(2): 241-246.

参考文献

[1] 李卫娜,王猛,刘瑞娟,等.慢性心力衰竭患者血清内皮细胞特异性分子1和斯钙素1表达水平及心功能相关性研究[J].中国心血管病研究,2023,21(7):632-637.
[2] 张金彪,李晓明,邢婉琳,等.血栓分子标志物预警全膝关节置换后并发静脉血栓栓塞的作用[J].中国组织工程研究,2023,27(4):572-577.
[3] 燕建锋,姚娟,高洁,等.血清NEP、PTX3及H-FABP在慢性心力衰竭的表达水平及与疾病的相关性分析[J].现代生物医学进展,2023,23(2):309-312.
[4] 关杨,刘新民,郭飞,等.血清多种标志物联合预测慢性心力衰竭患者心室重构及预后的临床研究[J].心肺血管病杂志,2022,41(4):338-343.
[5] 李延芳,顾方方,闵国美,等.慢性心力衰竭合并肺炎支原体感染外周血miRNA-21/PTEN表达与心肌损伤和预后的关系[J].中华医院感染学杂志,2022,32(22):3386-3390.
[6] 黄青青,李书珍,杜晶晶,等.基于生物信息学对扩张型心肌病与慢性心力衰竭共同生物标志物的预测[J].解剖学杂志,2022,45(5):439-444.
[7] 魏治静,裴晓萌,宋温婷,等.两种心衰标志物荧光免疫层析联合检测技术研究[J].中国免疫学杂志,2023,39(7):1494-1499.
[8] 王新庄,孟建涛.慢性心力衰竭患者血清lncRNA MALAT1的表达水平及其临床意义[J].现代检验医学杂志,2022,37(1):141-144.
[9] 王凯,刘茜.慢性心力衰竭患者血清MR-ProADM、Gal-3、GDF-15表达及临床意义[J].检验医学与临床,2022,19(10):1390-1394.
[10] 马怀敏,王志方.血清生物标志物联合超声心动图预测老年ST段抬高型心肌梗死合并射血分数保留型心力衰竭的临床价值[J].中国心血管病研究,2022,20(1):41-46.
[11] 杨晓妍,唐玉洁,梁颖,等.血清Syndecan-4、TIMP-1与STEMI患者冠状动脉病变血管支数、超声心动图参数的关系[J].疑难病杂志,2023,22(3):241-246.
[12] 龚倩,黎东,李郁,等.循环miRNA-208a在射血分数降低性心力衰竭的诊断价值研究[J].河北医学,2023,29(10):1698-1704.
[13] 黄卓,曾振宇,李佳,等.心力衰竭患者Circ-PALLD的高表达受转录因子GATA4的转录调控[J].南方医科大学学报,2023,43(8):1371-1378.
[14] 靳绵绵,靳思思.硫氧还蛋白1与急性心力衰竭患者预后的相关性研究[J].华南国防医学杂志,2022,36(3):191-194.
[15] 赵海专,魏丽琴.充血性心力衰竭患者血清hs-CRP、cTnI及CK-MB的表达及其临床意义[J].武汉大学学报(医学版),2022,43(2):262-265276.
[16] 丁梦影,种莹.慢性心力衰竭不同心功能分级患者hs-cTnT与心肌纤维化指标变化[J].川北医学院学报,2023,38(2):245-248.
[17] 李伟,潘婉,杨钱,等.lncRNA MALAT1和miR-203在慢性心力衰竭患者中的表达水平及临床意义[J].检验医学与临床,2022,19(10):1306-1309,1313.
[18] 高蓉蓉,徐芳,祝绪,等.全血细胞衍生的炎症标志物对急性心力衰竭患者的长期预后价值[J].临床心血管病杂志,2022,38(12):980-987.
[19] 赵书程,罗志会,漆星,等.sST2与心肌标志物对血液透析患者合并心力衰竭的预测价值分析[J].成都医学院学报,2023,18(1):69-73.
[20] 王彩君,宋志会,陈瑞,等.基于代谢组学探讨加参方对慢性心力衰竭模型大鼠的作用及机制[J].天津中医药,2022,39(12):1574-1582.
[21] 何莉,何蔺,杨刚.血清长链非编码RNA HCG15和微小RNA-24在慢性心力衰竭患者中的表达及临床意义[J].岭南心血管病杂志,2022,28(5):444-447,474.
[22] 李明瑞. 血清可溶性ST2在心力衰竭中的研究进展[J].海南医学,2022,33(15):2004-2007.
[23] 戴嘉懿,周蕾.生长分化因子15与心血管疾病:从机制到临床[J].实用心脑肺血管病杂志,2022,30(5):125-128.
[24] 薛俊芳,王涵.慢性心力衰竭患者外周血lncRNA MIAT和miR-214水平变化及与预后关系[J].检验医学与临床,2022,19(23):3253-3257.
[25] 赵增光,刘全未.胰岛素样生长因子结合蛋白7早期识别急性心力衰竭患者心脏结构和功能异常的价值[J].心脑血管病防治,2022,22(5):27-29,33.
[26] TRIPOSKIADIS F,XANTHOPOULOS A,PARISSIS J,et al.Pathogenesis of chronic heart failure:Cardiovascular aging,risk factors,comorbidities,and disease modifiers[J].Heart Fail Rev,2022,27(1):337-344.
[27] BUTLER J,RICH J.Epidemiology of heart failure and the discovery of the cardioprotective effects of SGLT2 inhibitors[J].JACC Heart Fail,2024,12(6S):S1-S3.
[28] 姚慧慧,蒋建青.利伐沙班对心力衰竭合并心房颤动患者凝血因子及预后情况的效果观察[J].广州医药,2024,55(2):151-156.