老年慢性心力衰竭患者血清心型脂肪酸结合蛋白和S-100B蛋白水平变化的临床意义

Xu Chen, Hong-bo Zhang, Wen Li, Yao Yao, Yunyun Xue, Mei-jia Shen, Liu-wei Zhang, Lichao Sun
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摘要

目的探讨老年慢性心力衰竭患者血清心脏型脂肪酸结合蛋白(H-FABP)和S100钙结合蛋白B(S-100B)水平的变化及其临床意义。方法选择160例在我院接受治疗的慢性心力衰竭患者,80例接受定期检查的健康人作为正常对照。比较不同心功能分级患者的血清H-FABP和S-100B水平以及心功能指数评分。分析心力衰竭患者血清H-FABP和S-100B水平与N-末端B型前钠肽(NT-proBNP)和心功能指数评分的相关性。比较血清H-FABP、S-100B和NT-proBNP检测心力衰竭的敏感性、特异性和准确性。结果老年慢性心力衰竭患者血清H-FABP、S-100B和NT-proBNP水平随心功能分级的升高而升高(F=9.823、11.573和13.056,P=0.013、0.000和0.000),老年心力衰竭患者血清H-FABP和S-100B水平与血清NT-proBNP水平、心功能分级和左心室舒张末期内径(LVEDd)呈正相关(r=0.527、0.510和0.487,P=0.008、0.003和0.002;r=0.604、0.496和0.533,P=0.006、0.005和0.003),血清H-FABP联合S-100B检测心力衰竭的敏感性、特异性和准确性分别为93.2%、91.6%和95.7%。结论老年心力衰竭患者血清H-FABP和S-100B水平较高,与血清NT-proBNP水平、心功能分级和LVED。关键词:心力衰竭;脂肪酸结合蛋白;钙结合蛋白
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Clinical significance of serum level changes of heart-type fatty acid-binding protein and S-100B protein in elderly patients with chronic heart failure
Objective To investigate serum level changes of heart-type fatty acid-binding protein(H-FABP)and S100 calcium-binding protein B(S-100B)protein in elderly patients with chronic heart failure and their clinical significance. Methods A total of 160 patients with chronic heart failure treated at our hospital were recruited, and 80 healthy individuals receiving regular check-ups were enrolled as normal controls.Serum levels of H-FABP and S-100B and cardiac function index scores were compared between patients with different cardiac function grades.Correlations of serum H-FABP and S-100B levels with N-terminal pro-B-type natrlure tiepeptide(NT-proBNP)and with cardiac function index scores in heart failure patients were analyzed.The sensitivity, specificity and accuracy of serum H-FABP, S-100B and NT-proBNP for heart failure detection were compared. Results Serum levels of H-FABP, S-100B and NT-proBNP in elderly patients with chronic heart failure were elevated with increased cardiac function grading(F=9.823, 11.573 and 13.056, P=0.013, 0.000 and 0.000), and serum levels of H-FABP, S-100B and NT-proBNP were higher in elderly patients with heart failure than in the control group(P<0.05). Serum levels of H-FABP and S-100B were positively correlated with serum NT-proBNP levels, cardiac function grading and left ventricular end-diastolic diameter(LVEDd)(r=0.527, 0.510 and 0.487, P=0.008, 0.003 and 0.002; r=0.604, 0.496 and 0.533, P=0.006, 0.005 and 0.003), and were negatively correlated with left ventricular ejection fraction(LVEF)(r=-0.536 and-0.528, P=0.005 and 0.008). The sensitivity, specificity and accuracy of serum H-FABP combined with S-100B for heart failure detection were 93.2%, 91.6% and 95.7%, respectively. Conclusions Serum levels of H-FABP and S-100B are high in elderly patients with heart failure, and they are correlated with serum NT-proBNP levels, cardiac function grading and LVEDd.H-FABP combined with S-100B has a high positive rate for heart failure detection. Key words: Heart failure; Fatty acid-binding proteins; Calcium-binding proteins
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