| Objective To explore the clinical value of serum soluble growth-stimulating gene 2protein(sST2),galectin-3(Galectin-3),and N-terminal B-type natriuretic peptide(NT-pro BNP)in the diagnosis,grading,and predicting poor prognosis of chronic heart failure.Methods A selection of 121 patients with chronic heart failure(CHF)who were diagnosed in the First Affiliated Hospital of Bengbu Medical College from February2019 to February 2020 and were diagnosed strictly according to the "Chinese Heart Failure Diagnosis and Treatment Guidelines 2018"(excluded incomplete data,insufficient follow-up time or lost patients)were selected as chronic heart failure group(CHF group).After admission,their cardiac function was evaluated according to the New York College of Cardiology(NYHA)grading standards and divided into three groups: NYHA Ⅱ(n = 43),NYHA Ⅲ(n = 44),and NYHA IV(n = 34),70 cases of non-heart failure patients with no severe liver and kidney insufficiency and age and gender-matched who were in our hospital during the same period were selected as controls group.All enrolled patients underwent routine laboratory and cardiac color Doppler ultrasound examinations.The clinical data and serum samples of the two groups of subjects were collected,the expression levels of serum sST2 and Galectin-3were detected by enzyme-linked immunosorbent assay(ELISA),and the expression level of serum NT-pro BNP was detected by chemical method.To analyze the value of sST2,Galectin-3,and NT-pro BNP in the diagnosis of CHF and cardiac function classification,according to the occurrence of adverse cardiovascular events(MACE)of CHF patients within 1 year after discharge from the hospital,evaluate three the clinical value of individual or combined testing for predicting poor prognosis.SPSS24.0 statistical software was used for statistical analysis,and P<0.05 indicated that the difference was statistically significant.Results 1.Compared with the control group,the proportion of hypertension,and the levels of sST2,Galectin-3,and NT-pro BNP in the CHF group were significantly increased,while the LVEF level was significantly reduced,and the differences were statistically significant(P<0.05).2.The levels of sST2,Galectin-3,NT-pro BNP increased with the increase of NYHA cardiac function classification,while the LVEF level decreased with the increase of NYHA cardiac function classification,and there were differences between groups statistical significance(P<0.01),Spearman correlation analysis showed: sST2,Galectin-3,NT-pro BNP and NYHA cardiac function grading were positively correlated(P<0.01),LVEF and NYHA cardiac function grading were negatively correlated(P<0.01),Pearson correlation analysis showed that: sST2,Galectin-3,and NT-pro BNP were positively correlated(P<0.01);sST2,Galectin-3,NT-pro BNP and LVEF were negatively correlated(P<0.01).3.The ROC curve was used to compare the diagnostic efficacy of sST2,Galectin-3,and NT-pro BNP on CHF.It was found that the area under the ROC curve of the combined detection of the three was the largest,namely AUC=0.941(95%CI 0.906-0.975,P<0.05),the highest sensitivity is 83.5%,which is better than single-factor detection.4.According to whether MACE occurred within 1 year of follow-up,the levels of sST2,Galectin-3,and NT-pro BNP in the MACE group were significantly higher than those in the non-MACE group,while the LVEF level significantly lower than the non-MACE group,the difference was statistically significant(P<0.01).5.Using the ROC curve to assess the predictive value of MACE in CHF patients showed that:sST2,Galectin-3,NT-pro BNP predicts CHF patients after discharge1 The area under the ROC curve AUC(95% CI)for MACE that occurred during the year was 0.864(0.801-0.928),0.813(0.737-0.889),and 0.856(0.788-0.924).In the two combined tests,the sST2+NT-pro BNP AUC(95% CI),the highest sensitivity was 0.897(0.842-0.951),90%(P<0.05),Galectin-3+NT-pro BNP had the highest specificity of87.3%,and the three combined detection AUC(95 %CI)is 0.898(0.844-0.951)with the highest predictive power(P<0.05).Conclusion 1.The levels of sST2,Galectin-3,NT-pro BNP are positively correlated with the NYHA heart function classification of chronic heart failure,and can be used to evaluate the severity of chronic heart failure.2.The combined detection of sST2,Galectin-3,and NT-pro BNP has a higher clinical application value than single-factor detection in assisting diagnosis of chronic heart failure and predicting poor prognosis. |
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