左心疾病相关性肺高压患者血清sCD137水平及临床意义

马金玉; 陈蕊; 王伦平; 刘培晶; 严金川; 梁仪

doi:10.13201/j.issn.1001-1439.2020.06.014

左心疾病相关性肺高压患者血清sCD137水平及临床意义

- 江苏大学附属医院心血管内科(江苏镇江, 212001)
基金项目:
国家自然科学基金（No：81970379）；江苏省自然科学基金（No：BK20181227）；镇江市社会发展项目（No：SH2018043）

详细信息

通讯作者: 刘培晶,E-mail:jdfylpj@sina.com

中图分类号: R543.2

收稿日期: 2020-01-18

修回日期: 2020-04-02

Levels and clinical implication of serum soluble CD137 in patients with pulmonary hypertension due to left heart disease

- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China

More Information

Corresponding author: LIU Peijing, E-mail: jdfylpj@sina.com

Received Date: 18 January 2020

Revised Date: 02 April 2020

摘要

摘要: 目的：检测左心疾病相关性肺高压（PH-LHD）患者血清可溶性CD137（sCD137）的水平并探讨其临床意义。方法：收集76例左心疾病（LHD）患者的临床资料，以肺动脉收缩压（PASP）≥40 mmHg （1 mmHg=0.133 kPa）作为肺高压（PH）的诊断依据，其中单纯LHD患者40例（LHD组），LHD合并PH患者36例（PH-LHD组），对照组为30例体检健康的成年人。血清sCD137水平采用ELISA法检测。结果：PH-LHD组血清sCD137水平高于LHD组和对照组，3组的血清sCD137水平分别为9.27（7.01，13.71） pg/ml、6.68（4.26，8.26） pg/ml、2.52（1.22，3.22） pg/ml，组间比较差异均有统计学意义（P<0.05）。相关性分析显示PH-LHD组血清sCD137水平与血肌酐、血浆B型尿钠肽（BNP）、左房内径（LAD）、左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）及PASP正相关，与左室射血分数（LVEF）呈负相关。Logistic回归分析显示，sCD137为PH-LHD的独立影响因素之一（P<0.05）。sCD137预测PH-LHD的受试者工作特征曲线下面积（AUC）为0.722（95%CI：0.607~0.837，P=0.001），最佳阈值为>8.22 pg/ml，敏感性为0.611，特异性为0.750，当联合BNP及三酰甘油/高密度脂蛋白胆固醇（TG/HDL-C）后预测PH-LHD的AUC为0.910（95%CI：0.841~0.980，P<0.001），最佳阈值为>0.53，敏感性为0.778，特异性为0.950。结论：PH-LHD患者血清sCD137水平较LHD患者升高，提示sCD137可能参与PH-LHD的发生发展。血清sCD137对LHD患者发生PH-LHD有一定预测价值，联合BNP及TG/HDL-C对PH-LHD的预测效果更佳。
- 可溶性CD137 /
- 左心疾病 /
- 肺高压
Abstract: Objective: The aim of the present study was to investigate the levels of serum soluble CD137(sCD137) in patients with pulmonary hypertension due to left heart disease(PH-LHD) and explore it's clinical significance.Method: The clinical data of 76 patients with LHD were collected, and PH was defined by pulmonary artery systolic pressure (PASP) ≥ 40 mmHg, including 40 patients with LHD (LHD group) and 36 patients with PH-LHD (PH-LHD group), 30 healthy adults served as control group. Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of sCD137 in serum.Result: The levels of serum sCD137 in PH-LHD group was higher than that in LHD group and healthy control group. Serum sCD137 in three groups were 9.27(7.01, 13.71) pg/ml, 6.68(4.26, 8.26) pg/ml and 2.52(1.22, 3.22) pg/ml, in respectively. The differences were statistically significant (P<0.05) Serum sCD137 levels were positively correlated with serum creatinine, brain natriuretic peptide, left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and PASP, and negatively correlated with left ventricular ejection fraction. Logistic regression analysis showed that sCD137 was one of the independent influencing factors of PH-LHD (P<0.05).Receiver operating characteristic curves showed that the area under the curve(AUC) of sCD137 was 0.722(95%CI:0.607-0.837, P=0.001) in the prediction of PH-LHD, the cut-off value was >8.22 pg/ml, with the sensitivity at 0.611, specificity at 0.750.When combined with BNP and TG/HDL-C, the AUC of predicting PH-LHD was 0.910(95%CI:0.841-0.980, P<0.001), the cut-off value was >0.53, with the sensitivity at 0.778, specificity at 0.950.Conclusion: The serum sCD137 levels in patients with PH-LHD was higher than that in patients with LHD, suggesting that sCD137 may participate in the occurrence and development of PH-LHD.A certain value was showed in sCD137 of predicting the occurrence of PH-LHD in LHD patients which was better when combined with BNP and TG/HDL-C.
- soluble CD137 /
- left heart disease /
- pulmonary hypertension

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