设为首页 电子邮箱 联系我们

本刊最新招聘信息请见“通知公告”!  本刊投稿系统试运行中,欢迎投稿!如投稿有问题,可直接将稿件发送至zgyy8888@163.com

 

主管单位:中华人民共和国   

国家卫生健康委员会

主办单位:中国医师协会
总编辑:
杨秋

编辑部主任:吴翔宇

邮发代号:80-528
定价:28.00元
全年:336.00元
Email:zgyy8888@163.com
电话(传真):010-64428528;
010-64456116(总编室)

                  

过刊目录

2021 年第 5 期 第 16 卷

高水平血清可溶性致瘤抑制素2扩张型心肌病患儿的生存状况分析

Survival analysis for children with dilated cardiomyopathy under the condition of high serum level of soluble suppression of tumorigenicity 2

作者:焦萌王志远吕震宇金梅

英文作者:Jiao Meng Wang Zhiyuan Lyu Zhenyu Jin Mei

单位:首都医科大学附属北京安贞医院小儿心脏中心北京市心肺血管疾病研究所100029

英文单位:Pediatric Cardiac Center Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

关键词:扩张型心肌病;可溶性致瘤抑制素2;生存状况

英文关键词:Dilatedcardiomyopathy;Solublesuppressionoftumorigenicity2;Survivalstatus

  • 摘要:
  • 目的 探讨高水平血清可溶性致瘤抑制素2(sST2)扩张型心肌病(DCM)患儿的生存状况。方法 选取20159月至20193月于首都医科大学附属北京安贞医院就诊的149DCM患儿,根据临床表现和影像学、实验室检查结果,最终纳入104例。记录患儿的基线资料,检测血清sST2水平。记录复合终点事件(心脏移植、心力衰竭及死亡)发生率,多因素Cox回归模型分析不同sST2水平DCM患儿复合终点事件发生风险以及性别、是否服用β受体阻滞剂、是否有既往心力衰竭史与血清sST2间的交互作用。结果 104DCM患儿血清sST2中位水平为23.4(19.730.9)μg/L,根据sST2水平四分位数,将患儿分为Q1组(≤19.7 μg/L26例)、Q2组(>19.7~23.4 μg/L26例)、Q3组(>23.4~30.9 μg/L26例)、Q4组(>30.9 μg/L26例)。104DCM患儿中位随访时间为682536792dQ1组[11.5%3/26)]、Q2组[15.4%4/26)]、Q3组[26.9%7/26)]、Q4组[65.4%17/26)]复合终点事件发生率比较,差异有统计学意义(P0.001)。多因素Cox风险回归模型分析显示,在校正年龄、性别、左心室射血分数、左心室舒张末期内径Z分数、B型脑钠肽、是否应用β受体阻滞剂及既往心力衰竭史后,按sST2四分位水平分组,Q4组患儿发生复合终点事件的风险最高(风险比=9.1795%置信区间:2.31~36.49P=0.002),而将sST2作为连续变量,血清sST2水平每增加1 μg/L,复合终点事件发生风险增加5.00% (风险比=1.05, 95%置信区间:1.03~1.07, P0.001)。限制性立方样条曲线显示,复合终点事件发生风险随血清sST2水平增加而增加,呈现J型关系。将患儿按照性别、是否服用β受体阻滞剂以及有无既往心力衰竭史进行分层分析,结果显示,Q4组复合终点事件发生风险均较高。sST2水平与上述变量均无显著交互作用(均P0.05)。Kaplan-Meier生存曲线分析显示,Q4组无事件生存率最低(Log-rank χ2=18.544P<0.001)。结论 高水平血清sST2DCM患儿发生心脏移植、心力衰竭及死亡的危险因素。

  • Objective To investigate the survival of children with dilated cardiomyopathy(DCM) under the condition of high serum level of soluble suppression of tumorigenicity 2 (sST2). Methods From September 2015 to March 2019, 149 children with DCM admitted to Beijing Anzhen Hospital, Capital Medical University were selected. According to the clinical manifestations and imaging, laboratory examination results, there were 104 children enrolled finally. The baseline data of children were recorded, and serum sST2 level was measured. The incidence of composite endpoint events (cardiac transplantation, heart failure and death) were recorded. Multivariate Cox regression model was used to analyze the risk of composite endpoint events and the interaction between gender, β blockers use, history of heart failure and serum sST2. Results The median serum sST2 level in 104 children with DCM was 23.4(19.7, 30.9)μg/L. According to sST2 level quartiles, they were divided into Q1 group(19.7 μg/L, 26 cases), Q2 group(>19.7-23.4 μg/L, 26 cases), Q3 group(>23.4-30.9 μg/L, 26 cases) and Q4 group(>30.9 μg/L, 26 cases). The median follow-up time of 104 children was 682(536,792)d. There was significant difference in incidence of composite endpoint events among Q1 group11.5%3/26)], Q2 group15.4%4/26)], Q3 group26.9%7/26)] and Q4 group65.4%17/26)](P<0.001). After adjustment for age, gender, left ventricular ejection fraction, Z fraction of left ventricular end diastolic diameter, brain natriuretic peptide, β-blockers use and previous history of heart failure, the multivariate Cox regression model analysis showed that children in Q4 group had the highest risk of composite endpoint events by grouping with sST2 quartile level hazard ratio=9.17, 95% confidence interval(CI): 2.31-36.49, P=0.002. Using sST2 as a continuous variable, the serum sST2 level increased by 1 μg/L, and the risk of composite endpoint events increased by 5%( hazard ratio=1.05, 95%CI:1.03-1.07, P<0.001). The restricted cubic spline curve showed that the risk of composite endpoint events increased with the increase of serum sST2 level, presenting a J-shaped relationship. Stratified analysis was conducted on gender, β-blockers use and history of heart failure, and showed that the risks of composite endpoint events in Q4 group were higher. There were no significant interactions between sST2 level and above variables(all P>0.05). The Kaplan-Meier survival curve analysis showed that the Q4 group had the lowest event-free survival rate(Log-rank χ2=18.544, P<0.001). Conclusion High serum level of sST2 is a risk factor for cardiac transplantation, heart failure and death in DCM children.

copyright 《中国医药》杂志编辑部
地址:北京市朝阳区安贞路2号首都医科大学附属北京安贞医院北楼二层
电话:010-64456116 传真:010-64428528 邮编:100029 Email: zgyy8888@163.com
网址:www.chinamedicinej.com 京ICP备2020043099号-3

当您在使用本网站投稿遇到困难时,请直接将稿件投送到编辑部邮箱zgyy8888@163.com。







安卓


苹果

关闭