sST2、FGF-23、sCD40L对维持性血液透析患者心血管事件发生的预测价值

    Predictive value of sST2,FGF-23 and sCD40L for cardiovascular events in patientson maintenance hemodialysis

    • 摘要: 目的 探讨可溶性生长刺激表达基因2蛋白(soluble growth-stimulation expressed gene protein 2,sST2)、成纤维细胞生长因子23(fibroblast growth factor 23,FGF-23)、可溶性CD40配体(soluble CD40 ligand,sCD40L)对维持性血液透析患者心血管事件发生的预测价值。方法 本研究为单中心、回顾性、队列研究。纳入2015年2月至2019年12月于沈阳市第四人民医院进行血液透析6个月及以上患者80例作为研究组,随访至2020年6月。根据是否发生心血管事件分为心血管事件组(n=29)和非心血管事件组(n=51)。另取同期健康体检者40名作为对照组。检测并比较各组血清sST2、FGF-23、sCD40L水平,采用单因素及多因素Logistic回归分析影响维持性血液透析患者发生心血管事件的相关因素,绘制受试者工作曲线(receiver operating characteristic,ROC)分析sST2、FGF-23、sCD40L对维持性血液透析患者心血管事件发生的预测价值。结果 研究组sST2、FGF-23、sCD40L水平高于对照组(P<0.05);心血管事件组年龄、透析龄、sST2、FGF-23、sCD40L水平高于非心血管事件组(P<0.05);Logistic回归分析显示,年龄≥60岁、透析龄≥38个月、高水平sST2、FGF-23及sCD40L是维持性血液透析患者发生心血管事件的独立危险因素(P<0.05);由ROC曲线可知,血清sST2、FGF-23、sCD40L三者联合预测维持性血液透析患者发生心血管事件的AUC为0.901,高于三者单独检测的0.769、0.752、0.728(P<0.05)。结论 维持性血液透析发生心血管事件患者血清sST2、FGF-23、sCD40L水平有升高趋势,三者对维持性血液透析患者发生心血管事件具有一定的预测价值。

       

      Abstract: Objective To explore the predictive values of soluble growth-stimulation expressed gene protein 2(sST2), fibroblast growth factor 23(FGF-23) and soluble CD40 ligand(sCD40L) for the occurrence of cardiovascular events in patients on maintenance hemodialysis(MHD). Methods For this retrospective cohort study at a single center, 80 patients on MHD over 6 months between February 2015 and December 2019 were assigned into study group. They were followed up until June 2020. According to the presence or absence of cardiovascular events, they were divided into two groups of cardiovascular event(n=29) and non-cardiovascular event(n=51). During the same period, 40 healthy controls were selected as control group. The serum levels of sST2, FGF-23 and sCD40L were detected and compared among all groups. The relevant influencing factors of cardiovascular events were analyzed by univariate and multivariate Logistic regression analyses. The curves of receiver operating characteristic(ROC) were plotted for analyzing the predictive values of sST2, FGF-23 and sCD40L for cardiovascular events. Results The serum levels of sST2, FGF-23 and sCD40L were higher in study group than those in control group(P<0. 05). Age, dialysis age, levels of sST2, FGF-23 and sCD40L were higher in cardiovascular event group than those in non-cardiovascular event group(P<0. 05). Logistic regression analysis indicated that age ≥ 60 years, dialysis age ≥ 38 months and elevated levels of sST2, FGF-23 and sCD40L were independent risk factors of cardiovascular events in MHD patients(P<0. 05). And ROC curves revealed that area under curve(AUC) of serum levels of sST2 plus FGF-23 and sCD40L was 0. 901 for predicting cardiovascular events. It was higher than that of them alone(0. 769, 0. 752, 0. 728) (P<0. 05). Conclusion Elevated in MHD patients with cardiovascular events, the serum levels of sST2, FGF-23 and sCD40L have some predictive values for cardiovascular events.

       

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