目的 探讨半乳糖凝集素-3(galactose lectin-3,Gal-3)、血管生成素-2(angiopoietin-2,Ang-2)在致心律失常性右室发育不良/心肌病(arrhythmogenic right ventricular dysplasia/cardiomyopathy,ARVD/C)患者血清中的变化及其临床意义.方法 收集2019年6月至2021年6月治疗的80例ARVD/C患者作为研究组,选择同期健康体检者82例作为对照组.ARVD/C患者依据美国纽约心脏病协会(New York Heart Association,NYHA)心功能分级分为心功能Ⅱ级组24例,心功能Ⅲ级组25例,心功能Ⅳ级组31例.采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测两组血清Gal-3、Ang-2水平;采用受试者操作特征(receiver operating characteristic,ROC)曲线评估Gal-3、Ang-2对ARVD/C的诊断价值;Pearson法分析Gal-3、Ang-2水平的相关性;多因素logistic回归分析影响ARVD/C发生的危险因素.结果 研究组血清Gal-3与Ang-2水平明显高于对照组(P均<0.05).男性患者血清中Gal-3、Ang-2水平高于女性患者(P均<0.05).Gal-3、Ang-2水平随着NYHA心功能分级的升高而升高,各组间比较具有统计学意义(P均<0.05).ROC曲线结果显示,血清Gal-3诊断ARVD/C的AUC为0.814,最佳临界值为25.148 ng/mL;血清Ang-2诊断ARVD/C的AUC为0.764,最佳临界值为163.112 pg/mL;血清Gal-3与血清Ang-2联合诊断的AUC值(0.887)大于Gal-3、Ang-2单独诊断的AUC值(Z=1.712、2.685,P均<0.05).多因素logistic回归结果显示,Gal-3、Ang-2是影响ARVD/C发生的独立危险因素.结论 Gal-3与Ang-2在ARVD/C患者血清中水平上调,两者联合对ARVD/C具有较高的诊断价值.
Expression and Clinical Significance of Galactose Lectin-3 and Angiopoietin-2 in Serum of Patients with Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Objective To investigate the changes and clinical significance of galactose lectin-3(Gal-3)and angiopoietin-2(Ang-2)in the serum of patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy(ARVD/C).Methods 80 patients with ARVD/C in our hospital from June 2019 to June 2021 were selected as the study group,and 82 healthy subjects during the same period were selected as the control group.According to the New York Heart Association(NYHA)cardiac function classification,ARVD/C patients were divided into cardiac function class Ⅱ group(24 cases),cardiac function class Ⅲ group(25 cases),and cardiac function class Ⅳ group(31 cases).Serum levels of Gal-3 and Ang-2 were detected by enzyme-linked immunosorbent assay(ELISA);receiver operating characteristic(ROC)curve was applied to evaluate the diagnostic value of Gal-3 and Ang-2 for ARVD/C;the correlation of Gal-3 and Ang-2 levels was analyzed by Pearson method;Multivariate Logistic regression was applied to analyze the risk factors affecting the occurrence of ARVD/C.Results The serum levels of Gal-3 and Ang-2 in the study group were greatly higher than those in the control group(all P<0.05).Serum levels of Gal-3 and Ang-2 in male patients were higher than those in female patients,and the difference was statistically significant(all P<0.05).The levels of Gal-3 and Ang-2 increased with the increase of NYHA cardiac function classification(all P<0.05).ROC curve showed that the AUC of serum Gal-3 for the diagnosis of ARVD/C was 0.814,and the optimal critical value was 25.148 ng/mL;the AUC of serum Ang-2 for the diagnosis of ARVD/C was 0.764,and the optimal critical value was 163.112 pg/mL,the AUC value of serum Gal-3 combined serum Ang-2 to diagnosis(0.887)was greater than that of Gal-3 and Ang-2 alone(Z=1.712,2.685,all P<0.05).Multivariate logistic regression analysis of risk factors for ARVD/C showed that Gal-3 and Ang-2 were independent risk factors for ARVD/C.Conclusion The levels of Gal-3 and Ang-2 in the serum of ARVD/C patients are up-regulated,and the combination of the two has a high diagnostic value for ARVD/C.
Galectin-3Angiopoietin-2Arrhythmogenic right ventricular dysplasia/cardiomyopathyDiagnostic value