血浆periostin蛋白、cTnI及BNP与扩张性心肌病患者室壁应力的相关性研究

摘要 目的：探讨血浆periostin蛋白、肌钙蛋白（troponin I，cTnI）、脑钠肽（brain natriureticpe ptide，BNP）与扩张性心肌病患者室壁应力（mean wall stress，MWS）的相关性及其对扩张性心肌病预后评估价值。方法：选择2019年3月~2022年3月期间我院收治89例扩张性心肌病患者和同期体检79例健康者作为研究组及对照组，均检测血浆periostin蛋白、cTnI、BNP水平以及MWS变化。随访患者出院一年心血管不良事件发生情况，进行相关统计学分析，并探讨其临床价值。结果：研究组血浆periostin蛋白、cTnI、BNP以及MWS水平均显著高于对照组（P＜0.05）；Pearson相关性分析显示，血浆periostin蛋白、cTnI、BNP水平与MWS均为正相关（r=0.619，0.428，0.665；P＜0.05）；预后良好患者血浆periostin蛋白、cTnI、BNP以及MWS水平均显著低于预后不良患者（P＜0.05）；ROC曲线显示，分别用血浆periostin蛋白、cTnI、BNP、MWS评估患者预后AUC相应值为0.973、0.702、0.803、0.802，血浆periostin蛋白、cTnI、BNP分别联合MWS评估患者预后相应的AUC值为0.984、0.810、0.857。结论：扩张性心肌病患者血浆periostin蛋白、cTnI及BNP水平与MWS及疾病预后相关，血浆periostin蛋白、cTnI及BNP分别联合MWS对疾病预后具有一定评估价值。

Correlation of Plasma Periostin, cTnI and BNP with Wall Stress in Patients with Dilated Cardiomyopathy

ABSTRACT Objective: To investigate the relationship between plasma periostin protein, cardiac troponin I (cTnI), brain natriuretic peptide (BNP) and changes of mean wall stress (MWS) in patients with dilated cardiomyopathy (DCM), and the prognostic value in dilated cardiomyopathy. Methods: A total of 89 DCM patients admitted to the hospital and 79 healthy controls from March 2019 to March 2022 were selected as the study group and the control group, respectively. The changes in plasma periostin protein, cTnI, BNP and MWS were measured. And the above four indexes were compared between the two groups.Followed up the incidence of cardiovascular adverse events in patients discharged from hospital for one year, conduct relevant statistical analysis, and analyzed.their clinical significance. Results: The levels of plasma periostin protein, cTnI, BNP and MWS in study group were significantly higher than those in control group (P<0.05). Pearson correlation analysis showed that levels of plasma periostin protein, cTnI and BNP were all positively correlated with MWS (r=0.619, 0.428, 0.665, P<0.05). The levels of plasma periostin protein, cTnI, BNP and MWS in patients with good prognosis were significantly lower than those with poor prognosis (P<0.05). ROC curves showed that AUC values of plasma periostin protein, cTnI, BNP and MWS for predicting prognosis were 0.973, 0.702, 0.803 and 0.802, respectively. AUC values of plasma periostin protein, cTnI and BNP respectively combined with MWS for predicting prognosis were 0.984, 0.810 and 0.857. Conclusion: The plasma periostin protein, cTnI and BNP are abnormal in DCM patients, which are closely related to MWS changes. Plasma periostin protein, cTnI and BNP respectively combined with MWS are of certain value in predicting prognosis of DCM.