血清TIMP-4水平在老年慢性心力衰竭早期诊断及预后评估中的价值

发布时间：2018-03-10 05:21

  本文选题：慢性心力衰竭　切入点：组织型金属蛋白酶抑制剂　出处：《山东医药》2017年36期 　论文类型：期刊论文

【摘要】：目的探讨血清组织型金属蛋白酶抑制剂4(TIMP-4)水平对老年慢性心力衰竭(CHF)早期诊断及预后评估的价值。方法选择老年CHF患者160例(CHF组),其中轻度68例、重度92例,另选体检健康的老年志愿者40例(对照组)。采用彩色多普勒超声诊断仪检测两组左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)。采集肘静脉血,采用双抗体夹心ELISA法检测血清TIMP-4。采用受试者工作特征(ROC)曲线分析血清TIMP-4对老年CHF的早期诊断价值。老年CHF患者出院3、6、9个月复查心脏彩超,统计心脏事件的发生情况。结果 CHF组LVEDD明显高于对照组,LVEF、TIMP-4明显低于对照组,以重度CHF患者上述指标变化更明显(P均0.05);相关分析显示,老年CHF患者血清TIMP-4水平与LVEF呈正相关关系(r=0.816,P0.05),与LVEDD呈负相关关系(r=-0.266,P0.05)。ROC曲线分析显示,血清TIMP-4诊断老年CHF的曲线下面积为0.916(95%CI:0.869~0.951),其cut off值为1.41 ng/m L,此时血清TIMP-4诊断老年CHF的敏感性为77.0%、特异性为92.0%。以血清TIMP-4水平的cut off值为截断值,将老年CHF患者分为TIMP-4高水平者(TIMP-41.41ng/m L)46例和TIMP-4低水平者(TIMP-4≤1.41 ng/m L)114例;TIMP-4高水平者和TIMP-4低水平者出院3个月无心脏事件生存率比较P0.05,而TIMP-4高水平者出院6、9个月无心脏事件生存率明显高于TIMP-4低水平者(P均0.05)。结论血清TIMP-4可作为老年CHF患者早期诊断和预后判断的预测指标之一。
[Abstract]:Objective to investigate the value of serum tissue metalloproteinase inhibitor (TIMP-4) in the early diagnosis and prognosis evaluation of chronic heart failure (CHF) in the elderly. The left ventricular end-diastolic diameter (LVEDDN), left ventricular ejection fraction (LVEF) and left ventricular ejection fraction (LVEF) were detected by color Doppler ultrasound in 40 healthy volunteers (control group). The serum TIMP-4 was detected by double antibody sandwich ELISA. The value of serum TIMP-4 in the early diagnosis of senile CHF was analyzed by using the operating characteristics of the subjects. Results the incidence of cardiac events in CHF group was significantly higher than that in control group, especially in severe CHF patients (P < 0.05). There was a positive correlation between serum TIMP-4 level and LVEF in elderly patients with CHF. There was a negative correlation between serum TIMP-4 level and LVEDD. The area under the curve of serum TIMP-4 in the diagnosis of senile CHF was 0.916 / 95 CI: 0.869 / 0.951 and the value of cut off was 1.41 ng/m / L. the sensitivity and specificity of serum TIMP-4 in the diagnosis of senile CHF were 77.0 and 92.0 respectively. The cut off value of serum TIMP-4 level was taken as truncation value. Elderly patients with CHF were divided into high TIMP-4 patients with TIMP-41.41ngP / mL and low TIMP-4 patients with TIMP-4 鈮，

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