| ObjectiveTo investigate the value of N-terminal pro-brain natriuretic peptide(NT-pro BNP),high sensitivity of cardiac troponin T(hs-c Tn T),soluble suppression of tumorigenicity 2(s ST2)and galectin 3(Gal-3)in the diagnosis and severity evaluation of elderly patients with chronic heart failure.MethodsA total of 109 elderly patients with chronic heart failure in Guangzhou Red Cross Hospital affiliated to Jinan University were selected as the experimental group,and 56 inpatients without heart failure were selected as the control group.According to NYHA cardiac function classification,the patients in the experimental group were divided into NYHA II group(n=33),NYHAIII group(n=55)and NYHA IV group(n=21).Blood levels of NT-pro BNP,hs-c Tn T,s ST2 and Gal-3 in the experimental group and the control group were measured by electrochemiluminescence and enzyme-linked immunosorbent assay(ELISA).Comparison of the blood levels of NT-pro BNP,hs-c Tn T,s ST2 and Gal-3 in the experimental group and the control group and the general clinical data of the two groups of patients.Markers with significant differences were compared by ROC curve,and the sensitivity and specificity of individual indexes were analyzed.The logistic regression model was established based on the selected meaningful indexes,and the Logistic regression equation of the meaningful index was calculated.The probability value(PRE)of the model was used to fit the receiver operating characteristic(ROC)curve,and sensitivity and specificity of the combined detection were analyzed.The differences of the selected indexes in different NYHA cardiac function classification groups were compared by rank sum test,and their value in evaluating the severity of cardiac function were analyzed.Result1.Concentrations of the four marker NT-pro BNP,hs-c Tn T,s ST2 and Gal-3 in experimental groups were 5151.80(3264.50,7788.50)pg/ml,0.04(0.02,0.91)μg/L,39.82(27.26,55.37)ng/ml,15.76(13.90,22.16)ng/ml,respectively;concentrations in control group were 164.85(107.873,225.673)pg/ml,0.011(0.01,0.02)μg/L,12.26(9.22,15.35)ng/ml,12.56(9.38,14.13)ng/ml,respectively.Levels of NT-pro BNP,hs-c Tn T,s ST2 and Gal-3 in the experimental group were significantly higher than that in the control group,and the difference was statistically significant(all P < 0.001).2.Levels of NT-pro BNP,hs-c Tn T,s ST2 and gal-3 in NYHA II group were 2673.00(170.40,3880.75)pg/ml,0.034(0.17,0.04)μg/L,16.49(14.02,20.65)ng/ml,14.22(12.75,15.12)ng/ml,respectively;levels in NYHA III group were 5930.00(4027.00,8231.00)pg/ml,0.038(0.024,0.10)μg/L,40.63(31.35,48.41)ng/ml,16.49(14.02,20.65)ng/ml;levels in NYHA IV group were7749.00(6632.50,8647.50),0.09(0.06,0.15)μg/L,90.40(69.51,139.84)ng/ml,25.12(22.20,32.98)ng/ml.Levels of NT-pro BNP,hs-c Tn T,s ST2 and Gal-3 in NYHA III group were significantly higher than that in NYHA II group,and the difference was statistically significant(all P<0.05).Levels of NT-pro BNP,hs-c Tn T,s ST2 and Gal-3 in NYHA IV group were significantly higher than that in NYHA III group and NYHA II group,and differences were statistically significant(all P<0.05).The levels of four biomarkers increased with the increase of NYHA cardiac function grade.3.Results of spearman correlation analysis showed that the blood levels of NT-pro BNP,hsc Tn T,s ST2 and Gal-3 in the experimental group were positively correlated with NYHA cardiac function grade(all P<0.001),and negatively correlated with LVEF(all P<0.001).4.The receiver operating characteristic curve(ROC)showed that the area under the curve(AUC)of blood NT-pro BNP,hs-c Tn T,s ST2 and Gal-3 in patients with chronic heart failure were0.905,0.879,0.855,0.833,respectively;sensitivity was 88.1%,81.7%,85.3%,72.5%,respectively;specificity was 91.1%,87.5%,85.7%,82.1%,respectively.The area under the ROC curve of the combined detection of four markers were larger than that of any single index,the AUC was 0.957,the sensitivity was 95.4%,and the specificity was 87.5%.Conclusion1.The concentrations of NT-pro BNP,hs-c Tn T,s ST2 and Gal-3 in elderly patients with chronic heart failure are significantly higher than those in patients without chronic heart failure.The combined detection of the four markers has higher diagnostic efficacy than single detection,and has a certain value in the diagnosis of elderly patients with chronic heart failure.2.NT-pro BNP,hs-c Tn T,s ST2 and Gal-3 were positively correlated with NYHA cardiac function grade and negatively correlated with LVEF in elderly patients with chronic heart failure.These four markers have important value in evaluating the severity of elderly chronic heart failure. |
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