基于简易危险分层探索血清sST2评估结缔组织病相关肺动脉高压病情严重程度的研究
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1.南京医科大学附属老年医院;2.南京医科大学第一附属医院

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国家自然科学基金项目(面上项目,重点项目,重大项目)


sST2 Evaluates the Severity of Connective Tissue Disease with Pulmonary Arterial Hypertension based on Simplified Risk Stratification
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    摘要:

    目的:基于简易危险分层探索血清可溶性生长刺激表达基因2蛋白(soluble growth stimulation expressed gene 2, sST2)水平在评估结缔组织病相关肺动脉高压(connective tissue disease associated pulmonary arterial hypertension, CTD-PAH)病情严重程度中的价值。方法:回顾性分析2017年1月至2021年11月期间在南京医科大学第一附属医院风湿免疫科由右心导管诊断的CTD-PAH患者临床资料。采用Excel表格收集患者基线及随访资料:血清sST2水平、人口统计学资料、原发病和PAH临床特征资料、治疗方案。主要研究终点是3年首次发生临床恶化事件。根据2018世界肺高压大会上发布的简易危险分层量表评估所有患者基线时危险分层水平。采用Pearson相关分析和线性回归分析评价sST2水平与CTD-PAH临床基线资料之间的相关性;采用ROC曲线分析,确定基线sST2水平区分中高危CTD-PAH患者的最佳阈值。结果:中高危患者的血清sST2水平显著高于低危患者[45.97(30.24-75.68)vs. 29.36(20.89-41.25)ng/mL,P=0.006]。ROC曲线分析提示sST2≥45.56 ng/mL可以识别中高危CTD-PAH患者,敏感性和特异性分别为56%和91%。结论:血清sST2水平与CTD-PAH患者病情严重程度相关,中高危患者血清中sST2水平明显高于低危患者。

    Abstract:

    Objective: Based on simplified risk stratification to explore the value of serum soluble growth stimulation expressed gene 2 (sST2) level in evaluating the severity of patients in connective tissue disease associated pulmonary arterial hypertension (CTD-PAH). Methods: This retrospective cohort study enrolled 48 CTD-PAH patients diagnosed by right heart catheterization (RHC) during Jan 2017 and Nov 2021. Baseline and follow-up data collected including: demographic data, clinical data of CTD and PAH, treatment option of CTD and PAH. The risk grade was calculated according to a simplified risk stratification model based on 2018 world symposium on pulmonary hypertension (WSPH). The clinical baseline data of CTD-PAH patients, RHC parameters and sST2 level were analyzed by Pearson, and the correlated parameters were further linearly regressed. The ROC curve was used to analyze the optimal threshold of sST2 for identifying low risk and intermediate-high risk CTD-PAH patients. Groups comparison were performed by the log-rank test. Results: CTD-PAH patients with intermediate-high risk the sST2 level is significantly higher than low risk, 45.97(30.24-75.68)vs. 29.36 (20.89-41.25) ng/mL. ROC curve analysis showed that sST2≥45.56 ng/mL identify intermediate-high risk CTD-PAH patients with sensitivity and specificity were 56% and 91%, respectively. Conclusions: sST2 level can reflect the severity of disease in patients with CTD-PAH.

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  • 收稿日期:2022-11-24
  • 最后修改日期:2023-03-17
  • 录用日期:2023-08-29
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