血CTRP5动态变化与舒张性心力衰竭患者疗效及预后的相关性研究

Study on the Correlation between Dynamic Changes of Blood CTRP5 and the Efficacy and Prognosis of Patients with Diastolic Heart Failure

摘要: 目的：分析血补体Clq/肿瘤坏死因子相关蛋白5 (CTRP5)动态变化与舒张性心力衰竭(DHF)患者疗效及预后的相关性，为临床治疗提供借鉴。方法：选取本院2021年1~12月的80例DHF患者(DHF组)及80例健康体检者(健康组)，均进行血CTRP5检测，对比其差异。DHF组均予以呋塞米联合螺内酯治疗，对比治疗前、后的血CTRP5水平。对DHF组患者进行疗效评估，根据评估结果分为有效组、无效组，对比不同疗效组患者CTRP5水平的差异。对DHF组患者出院后随访3年进行预后评估，根据预后情况，将生存者纳入预后良好组，死亡者纳入预后不良组，对比不同预后组患者CTRP5水平的差异。运用Logistic分析法，分析不良预后的影响因素；绘制受试者工作特征(ROC)曲线，分析CTRP5水平对预后的预测价值。结果：DHF组治疗前的CTRP5水平高于健康组，P < 0.05。DHF组患者治疗后的CTRP5水平低于治疗前，P < 0.05。DHF组80例患者中，显效29例，有效41例，无效10例，总有效率为91.94%；有效组的CTRP5水平低于无效组，P < 0.05。DHF组80例患者中，死亡11例，不良预后发生率为13.75% (11/80)；预后良好组的CTRP5水平低于预后不良组，P < 0.05。Logistic分析结果显示，年龄 ≥ 65岁、血压异常、血糖异常、血脂异常、CTRP5高水平是不良预后的危险因素。CTRP5水平对预后预测的AUC、灵敏度、特异度分别为0.815、72.15%、92.43%。结论：血CTRP5动态变化与DHF患者疗效及预后存在相关性，CTRP5水平监测可为患者的疗效评估及预后预测提供一定的参考价值。

Abstract: Objective: To analyze the correlation between the dynamic changes of blood complement Clq/tumor necrosis factor related protein 5 (CTRP5) and the efficacy and prognosis of patients with diastolic heart failure (DHF), and provide reference for clinical treatment. Method: Eighty DHF patients (DHF group) and 80 healthy subjects (healthy group) admitted to our hospital from January to December 2021 were enrolled. Serum CTRP5 levels were detected and compared between the two groups. All patients in the DHF group were treated with furosemide combined with spironolactone, and serum CTRP5 levels before and after treatment were compared. Efficacy evaluation was conducted in the DHF group, and patients were divided into effective group and ineffective group according to the evaluation results to compare CTRP5 levels. The DHF patients were followed up for 3 years after discharge for prognosis evaluation, with survivors included in the good prognosis group and decedents in the poor prognosis group to compare CTRP5 levels. Logistic analysis was used to explore influencing factors of poor prognosis, and receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of CTRP5 levels for prognosis. Result: The pre-treatment serum CTRP5 level in the DHF group was significantly higher than that in the healthy group (P < 0.05). After treatment, the serum CTRP5 level in the DHF group was lower than that before treatment (P < 0.05). Among 80 DHF patients, 29 cases showed marked efficacy, 41 cases showed efficacy, and 10 cases were ineffective, with an overall effective rate of 91.94%. The CTRP5 level in the effective group was lower than that in the ineffective group (P < 0.05). During follow-up, 11 patients died, with a poor prognosis incidence of 13.75% (11/80). The CTRP5 level in the good prognosis group was lower than that in the poor prognosis group (P < 0.05). Logistic analysis showed that age ≥ 65 years, abnormal blood pressure, abnormal blood glucose, abnormal blood lipids, and high CTRP5 level were risk factors for poor prognosis. The area under the ROC curve (AUC), sensitivity, and specificity of CTRP5 level for predicting prognosis were 0.815, 72.15%, and 92.43%, respectively. Conclusion: There is a correlation between the dynamic changes of blood CTRP5 and the efficacy and prognosis of patients with diastolic heart failure. Monitoring CTRP5 levels can provide certain reference value for evaluating the efficacy and predicting the prognosis of patients.