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Chest:左心衰竭的无创预后生物标志物可预测肺动脉高压患者的生存情况

2020-01-28 xing.T MedSci原创

由此可见,ST2和NT-proBNP是PAH患者较强且无创的预后生物标志物。尽管Gal3在左心衰竭中具有预后价值,但在PAH中无预测效能。在生存模型中添加ST2可显著提高模型的预测能力。

三种生物标记物,可溶性肿瘤发生抑制蛋白2(ST2)、半乳糖凝集素3(Gal3)和B型脑钠肽前体N末端(NT-proBNP)被批准用于左心衰竭的无创风险评估,并且小型观察研究表明它们对异源性肺动脉高压人群具有预后评估价值。近日,呼吸领域权威杂志chest上发表了一篇研究文章,研究人员评估了I型肺动脉高压(PAH)患者这些生物标志物与疾病严重程度和生存之间的关联。研究人员假设生物标志物的组合使用可提高生存模型的预后价值。

生物标志物测量值和临床数据来自2017名I型PAH成年人。研究人员使用多变量回归模型评估了生物标志物水平与临床变量(包括生存时间)之间的关联。似然比检验和Akaike信息标准用于比较生存模型。

较高的ST2和NT-proBNP与较高的肺内压和血管阻力以及较低的6分钟步行距离有关。较高的ST2和NT-proBNP水平与死亡风险增加相关(风险比分别为2.79、95%CI为2.21-3.53,p<0.001和1.84、95%CI为1.62-2.10,p<0.001)。在生存模型中增加ST2可显著改善模型拟合和预测能力。

由此可见,ST2和NT-proBNP是PAH患者较强且无创的预后生物标志物。尽管Gal3在左心衰竭中具有预后价值,但在PAH中无预测效能。在生存模型中添加ST2可显著提高模型的预测能力。

原始出处:

Catherine E. Simpson,et al.Noninvasive prognostic biomarkers for left heart failure as predictors of survival in pulmonary arterial hypertension.chest.2020.https://doi.org/10.1016/j.chest.2019.12.037

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    2020-12-01 Smile2680
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    2020-01-28 明天jing

    肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。

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