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血清可溶性生长刺激表达基因2蛋白在心力衰竭诊断及预后中的应用价值

[Application value of serum sST2 in diagnosis and prognosis of heart failure].

作者信息

Huang Shuizhen, Wei Qingchun, Zhi Xinyi, Wang Jiajia, Zhang Zhongying

机构信息

School of Public Health, Xiamen University, Xiamen 361100, Fujian, China.

Xiamen Humanity Hospital, Fujian Medical University, Xiamen 361100, Fujian, China.

出版信息

Sheng Wu Gong Cheng Xue Bao. 2020 Sep 25;36(9):1713-1722. doi: 10.13345/j.cjb.190587.

Abstract

The incidence of heart failure (HF) increases significantly as people age. HF remains a major concern in public health. Although remarkable achievements have been made to treat heart failure in recent years, the survival rate of patients is still very low and the prognosis is poor. The mortality rate within 5 years after the diagnosis of heart failure is up to 50%. If we can quickly and effectively diagnose heart failure and reasonably stratify according to the risk, it will provide a solid foundation for clinicians to formulate treatment plans. Biomarkers play an important role in the diagnosis, curative effect evaluation and prognosis of heart failure. Heart failure is a complex disease in which various pathophysiological processes are involved over time. When heart failure occurs, neuroendocrine system is activated. With the increase of blood volume and ventricular wall pressure, ventricular myocytes secrete NT-proBNP/BNP. Therefore, NT-proBNP/BNP can be used as a biomarker for diagnosis and prognosis of heart failure. However, NT-proBNP/BNP in plasma is easily affected by many factors such as age, sex, body type, left ventricular hypertrophy, tachycardia, right ventricular overload, hypoxemia, and kidney function. As a novel marker of heart failure, sST2 has attracted much attention in recent years. It can reflect the degree of myocardial fibrosis and predict whether ventricular remodeling will occur. It is worth noting that sST2 is not affected by age, gender and renal function and other factors. Also, with low reference change values and individuality index values, sST2 seems to be the best candidate for monitoring and guided therapy. In short, sST2 is one of the ideal indicators to evaluate heart failure. This review summarizes the research progress of sST2 in the diagnosis and prognosis of heart failure in recent years, and provides perspectives for its future development.

摘要

心力衰竭(HF)的发病率随着人们年龄的增长而显著增加。HF仍然是公共卫生领域的一个主要问题。尽管近年来在治疗心力衰竭方面取得了显著成就,但患者的生存率仍然很低,预后很差。心力衰竭诊断后5年内的死亡率高达50%。如果我们能够快速有效地诊断心力衰竭并根据风险进行合理分层,将为临床医生制定治疗方案提供坚实的基础。生物标志物在心力衰竭的诊断、疗效评估和预后中发挥着重要作用。心力衰竭是一种复杂的疾病,随着时间的推移涉及多种病理生理过程。当心力衰竭发生时,神经内分泌系统被激活。随着血容量和心室壁压力的增加,心室肌细胞分泌NT-proBNP/BNP。因此,NT-proBNP/BNP可作为心力衰竭诊断和预后的生物标志物。然而,血浆中的NT-proBNP/BNP很容易受到年龄、性别、体型、左心室肥厚、心动过速、右心室超负荷、低氧血症和肾功能等多种因素的影响。作为一种新型的心力衰竭标志物,可溶性ST2(sST2)近年来备受关注。它可以反映心肌纤维化的程度,并预测是否会发生心室重构。值得注意的是,sST2不受年龄、性别和肾功能等因素的影响。此外,由于参考变化值和个体指数值较低,sST2似乎是监测和指导治疗的最佳候选指标。简而言之,sST2是评估心力衰竭的理想指标之一。本综述总结了近年来sST2在心力衰竭诊断和预后方面的研究进展,并对其未来发展提供了展望。

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