血清Gal-3水平对先天性心脏病患儿肺高压的预测价值分析-东南大学学报医学版

血清Gal-3水平对先天性心脏病患儿肺高压的预测价值分析

单位：重庆市大足区人民医院儿科, 重庆 402360

分类号：R541.1

出版年·卷·期（页码）：2022·41·第六期（834-840）

摘要：

目的: 探讨血清半乳糖凝集素3(Gal-3)水平对预测先天性心脏病(CHD)患儿发生肺动脉高压(PAH)的临床价值。方法: 选取2017年3月至2021年7月我院收治的169例CHD患儿为研究对象,其中合并PAH患儿48例(设为CHD-PAH组),未合并PAH患儿121例(设为单纯CHD组);另外随机选取32例健康儿童作为对照组。采用酶联免疫吸附试验测定血清Gal-3水平。结果: CHD-PAH组患儿肺动脉平均压(mPAP)及N末端B型脑钠肽(NT-proBNP)、非对称性二甲基精氨酸(ADMA)、γ-谷氨酰转移酶(GGT)、Gal-3水平高于单纯CHD组(P＜0.05)。经单因素和多因素Logistic回归分析,血清Gal-3和ADMA水平是CHD-PAH的独立预测因子(P＜0.05)。血清Gal-3、ADMA水平及二者联合预测CHD-PAH的受试者工作特征曲线下面积分别为0.801(95%CI为0.733~0.868)、0.666(95%CI为0.578~0.754)、0.825(95%CI为0.759~0.891)。在CHD-PAH组患儿中,血清Gal-3水平与mPAP及NT-proBNP、GGT、肌酐(Cr)水平呈正相关,与经皮血氧饱和度、左心室射血分数呈负相关(P＜0.05),进一步校正混杂因素后经多元线性回归分析,血清Gal-3水平与mPAP仍呈正相关(β＝0.369,95%CI为0.152~0.571,P＝0.006)。结论: 血清Gal-3在CHD-PAH患儿中呈高表达,且与疾病的严重程度、mPAP、NT-proBNP水平显著相关。血清Gal-3水平对预测CHD患儿继发PAH风险具有较高的价值。

Objective: To investigate the clinical value of serum galectin-3(Gal-3) in predicting pulmonary arterial hypertension(PAH) in children with congenital heart disease(CHD). Methods: One hundred and sixty-nine children with CHD treated in our hospital from March 2017 to July 2021 were selected as our research subjects, including 48 children with PAH(CHD-PAH group) and 121 children without PAH(simple CHD group). In addition, 32 healthy children were randomly selected as control group. The levels of serum Gal-3 were measured by enzyme-linked immunosorbent assay. Results: The pulmonary artery mean pressure(mPAP), N-terminal B-type brain natriuretic peptide(NT-proBNP), asymmetric dimethylarginine(ADMA),γ-glutamyltransferase(GGT) and Gal-3 levels in CHD-PAH group were higher than those in simple CHD group(P＜0.05). Univariate and multivariate Logistic regression analyses showed that serum Gal-3 and ADMA were independent predictors of CHD-PAH(P＜0.05). The area under the receiver operating characteristic curve of serum Gal-3, ADMA and their combination to predict CHD-PAH were 0.801(95%CI 0.733-0.868), 0.666(95%CI 0.578-0.754)and 0.825(95%CI 0.759-0.891), respectively. For CHD-PAH children, serum Gal-3 level was positively correlated with mPAP, NT-probNP, GGT, creatinine(Cr), and negatively correlated with percutaneous blood oxygen saturation and left ventricular ejection fraction(P＜0.05). After further adjustment for confounding factors, multiple linear regression analysis showed that serum Gal-3 levels were still positively correlated with mPAP(β＝0.369, 95%CI 0.152-0.571, P＝0.006). Conclusion: Serum Gal-3 is highly expressed in CHD-PAH children and significantly correlated with disease severity and levels of mPAP and NT-proBNP. Serum Gal-3 has high diagnostic value in predicting the risk of secondary PAH in children with CHD.

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