目的 探讨血清硫酸乙酰肝素（HS）水平与慢性心力衰竭（CHF）患者心功能及高压氧（HBO）治疗预后的关系。 方法 选取2020年12月至2021年12月长治医学院附属和济医院心血管内科收治的88例CHF患者作为观察组，入院后均予以常规对症治疗，然后予以HBO辅助治疗。并选取同期80例健康体检者作为对照组。随访半年，根据预后情况将CHF患者分为预后良好组（n=63）和预后不良组（n=25）。采用酶联免疫吸附法检测患者血清HS水平，采用单因素分析不同预后患者的临床资料及血清HS水平，然后应用多因素COX回归分析影响CHF患者HBO治疗预后不良的危险因素，再以预后为自变量，绘制接受者操作特征ROC曲线。 结果 观察组患者血清HS水平［（85.45±3.67）μg/L］明显高于对照组［（77.63±3.25）μg/L］，差异有统计学意义（t=14.561，P<0.01）。不同心功能分级CHF患者血清HS水平比较差异有统计学意义（F趋势=76.336，P<0.01）。ROC曲线分析结果显示，血清HS最佳截断值为85.46 μg/L时，预测CHF患者HBO治疗预后不良的曲线下面积为0.79［95%CI：（0.683～0.824）］，灵敏度和特异度分别为82.33%、72.45%。单因素分析检测结果显示，预后不良组和预后良好组患者年龄、收缩压、血清HS水平及左室射血分数（LVEF）比较差异有统计学意义（P<0.01）；多因素COX回归分析结果显示，年龄≥70岁、LVEF<45%、血清HS≥85.46 μg/L是CHF患者HBO治疗预后不良的独立危险因素（OR>1，P<0.05）。 结论 血清HS水平随着CHF患者心功能分级的增加而逐渐升高，且与HBO治疗预后密切相关。 Objective To investigate the relationship between serum heparan sulfate （HS） level and cardiac function and the prognosis after hyperbaric oxygen （HBO） therapy in patients with chronic heart failure （CHF）. Methods A total of 88 CHF patients admitted to the Department of Cardiovascular Medicine of Heji Hospital affiliated to Changzhi Medical College from December 2020 to December 2021 were selected into observation group. They were given conventional symptomatic treatment upon admission， followed by HBO therapy. Another 80 healthy individuals who underwent physical examinations during the same period were selected into control group. A six-month follow-up was conducted， and based on the prognosis， the CHF patients were divided into good prognosis group （n=63） and poor prognosis group （n=25）. Enzyme-linked immunosorbent assay was used to measure the serum HS levels in the patients. Clinical data and serum HS levels of patients with different prognoses were analyzed using univariate analysis， and multiple-factor Cox regression analysis was employed to identify risk factors affecting the poor prognosis of HBO therapy in CHF patients. Receiver Operating Characteristic （ROC） curve was generated using prognosis as an independent variable. Results The serum levels of HS in the observation group［（85.45 ± 3.67） μg/L］were significantly higher than those in the control group［（77.63 ± 3.25） μg/L］， with statistically significant differences （t=14.561， P<0.01）. There were statistically significant differences among serum HS levels of CHF patients with different grades of cardiac function （F=76.336， P<0.01）. The ROC curve analysis showed that the optimal cutoff value for serum HS was 85.46 μg/L. The area under the curve （AUC） for predicting poor prognosis of HBO therapy in CHF patients was 0.79［95%CI： 0.683-0.824）］， with the sensitivity of 82.33% and the specificity of 72.45%. Univariate analysis revealed significant differences in age， systolic blood pressure， serum HS level， and left ventricular ejection fraction （LVEF） between the poor prognosis group and the good prognosis group （P<0.01）. Multivariate Cox regression analysis revealed that age≥70 years， LVEF<45%， and serum HS≥85.46 μg/L were the independent risk factors for poor prognosis of HBO therapy in the two groups （OR>1， P<0.05）. Conclusion Serum HS level gradually increases with the deterioration of cardiac function grade in CHF patients， which are closely related to the prognosis of HBO therapy.
Relationship between serum heparan sulfate and cardiac function and prognosis after hyperbaric oxygen therapy in patients with chronic heart failure
Objective To investigate the relationship between serum heparan sulfate （HS） level and cardiac function and the prognosis after hyperbaric oxygen （HBO） therapy in patients with chronic heart failure （CHF）. Methods A total of 88 CHF patients admitted to the Department of Cardiovascular Medicine of Heji Hospital affiliated to Changzhi Medical College from December 2020 to December 2021 were selected into observation group. They were given conventional symptomatic treatment upon admission， followed by HBO therapy. Another 80 healthy individuals who underwent physical examinations during the same period were selected into control group. A six-month follow-up was conducted， and based on the prognosis， the CHF patients were divided into good prognosis group （n=63） and poor prognosis group （n=25）. Enzyme-linked immunosorbent assay was used to measure the serum HS levels in the patients. Clinical data and serum HS levels of patients with different prognoses were analyzed using univariate analysis， and multiple-factor Cox regression analysis was employed to identify risk factors affecting the poor prognosis of HBO therapy in CHF patients. Receiver Operating Characteristic （ROC） curve was generated using prognosis as an independent variable. Results The serum levels of HS in the observation group［（85.45 ± 3.67） μg/L］were significantly higher than those in the control group［（77.63 ± 3.25） μg/L］， with statistically significant differences （t=14.561， P<0.01）. There were statistically significant differences among serum HS levels of CHF patients with different grades of cardiac function （F=76.336， P<0.01）. The ROC curve analysis showed that the optimal cutoff value for serum HS was 85.46 μg/L. The area under the curve （AUC） for predicting poor prognosis of HBO therapy in CHF patients was 0.79［95%CI： 0.683-0.824）］， with the sensitivity of 82.33% and the specificity of 72.45%. Univariate analysis revealed significant differences in age， systolic blood pressure， serum HS level， and left ventricular ejection fraction （LVEF） between the poor prognosis group and the good prognosis group （P<0.01）. Multivariate Cox regression analysis revealed that age≥70 years， LVEF<45%， and serum HS≥85.46 μg/L were the independent risk factors for poor prognosis of HBO therapy in the two groups （OR>1， P<0.05）. Conclusion Serum HS level gradually increases with the deterioration of cardiac function grade in CHF patients， which are closely related to the prognosis of HBO therapy.
万方数据
