左心室射血分数联合血管生成素2对慢性心力衰竭患者预后的评估价值

Prognostic value of left ventricular ejection fraction combined with angiogenin-2 in chronic heart failure

摘要:

目的：探讨慢性心力衰竭（chronic heart failure，CHF）患者左室射血分数（left ventricular ejection fraction，LVEF）联合血管生成素2（angiogenin-2，Ang2）在慢性心衰预后评估中的价值。方法：测定143例2010年1月至2012年12月慢性心衰住院病人的LVEF和血管生成素2，每3个月随访1次，随访3年。以心血管疾病死亡为终点事件。用logistic回归对3年死亡危险因素分析，ROC曲线分析LVEF联合Ang2对慢性心衰病人预后的判定。结果：患者平均年龄为（69.56±6.14）岁，男性病人占66.43%（n=95），22.38%的患者（n=32）在随访期间因心血管事件死亡。多项logistic回归分析显示：年龄（OR=0.92，95%CI=1.03~1.18，P=0.002），BMI（OR=1.53，95%CI=1.26~1.84，P=0.012），SBP（OR=1.06，95%CI=1.01~1.10，P=0.012），LVEF（OR=0.89，95%CI=0.81~0.94，P=0.001），Lg（BN）（OR=4.83，95%CI=1.75~12.78，P=0.001），Lg（Ang2）（OR=2.29，95%CI=1.03~5.53，P=0.008），肌酐（OR=2.93，95%CI=1.44~6.12，P=0.012），是慢性心衰预后的独立危险因子。ROC分析显示LVEF & Ang2（auROC=0.847，95%CI=0.770~0.902）具有比LVEF（auROC=0.778，95%CI=0.701~0.843）和Ang2（auROC=0.716，95%CI=0.634~0.788）更好的预后评估价值（P＜0.001）。结论：LVEF联合血管生成素2对慢性心衰患者预后具有较好的评估价值。

Abstract:

Objective：To investigate the prognostic value of left ventricular ejection fraction（LVEF） combined with angiogenin-2（Ang2） in chronic heart failure（CHF）. Methods：LVEF and angiogenin-2 of 143 patients with chronic heart failure were measured from January 2010 to December 2012. The patients were followed up for one time every 3 months，and the follow-up period was 3 years. Cardiovascular death was considered as the end event. Logistic regression was used to analyze the risk factors for death in 3 years. ROC curve was used to analyze the effect of LVEF combined with Ang2 on the prognosis of patients with CHF. Results：The average of the patients was （69.56±6.14） years old. The male patient accounted for 66.43% of all patients（n=95） and 22.38%（n=32） patients died of cardiovascular events during follow-up. Multinomial logistic regression analysis showed that age（OR=0.92，95%CI=1.03~1.18，P=0.002），BMI（OR=1.53，95%CI=1.26~1.84，P=0.012），SBP（OR=1.06，95%CI=1.01~1.10，P=0.012），LVEF（OR=0.89，95%CI=0.81~0.94，P=0.001），Lg（BN）（OR=4.83，95%CI=1.75~12.78，P=0.001），Lg（Ang2）（OR=2.29，95%CI=1.03~5.53，P=0.008），Creatinine（OR=2.93，95%CI=1.44~6.12，P=0.012） are the independent risk factors for the prognosis of CHF. ROC analysis showed that LVEF combined with Ang2（auROC=0.847，95%CI=0.770~0.902） has better prognostic value than LVEF（auROC=0.778，95%CI=0.701~0.843） and Ang2（auROC=0.716，95%CI=0.634~0.788），P＜0.001. Conclusion：The combination of LVEF and Ang2 in the prognosis of patients with chronic heart failure seems to be a promising and useful clinical tool.