慢性心力衰竭患者血浆中成纤维细胞生长因子-23和半乳糖凝集素-3水平与贫血的相关性

Correlation of plasma fibroblast growth factor-23 and galectin-3 levels with anemia in patients with chronic heart failure

摘要:

目的 贫血对心力衰竭患者的预后具有重要影响,本研究主要探讨慢性心力衰竭患者血浆成纤维细胞生长因子-23(FGF-23)和半乳糖凝集素-3(Gal-3)水平与贫血的相关性。方法 回顾性分析2018年5月至2019年3月陕西省汉中市中心医院心血管内科收治的因慢性心力衰竭急性发作住院的患者临床资料,共95例。依据是否贫血分为2组:贫血组(n＝47)和非贫血组(n＝48)。对比2组患者临床资料。采用SPSS 25.0软件进行统计分析。采用logistic回归分析比较各相关因素对贫血的影响。受试者工作特征(ROC)曲线分析各指标预测心力衰竭患者贫血的价值。结果 2组患者的血红蛋白(Hb)、FGF-23、Gal-3、尿素氮、胱抑素C、肌酐间差异具有统计学意义(P<0.05),且Hb与FGF-23(r=-0.470)、Gal-3(r=-0.379)、尿素氮(r=-0.330)、胱抑素C(r=-0.319)、肌酐(r=-0.282)呈显著负相关(均P＜0.01)。多因素logistic回归分析显示,FGF-23(OR=1.02,95%CI 1.011~1.030)、Gal-3(OR=1.05,95%CI 1.004~1.102)和尿素氮(OR=1.23,95%CI 1.030~1.481)是心力衰竭患者贫血的独立危险因素(P＜0.05)。ROC曲线分析显示,FGF-23对贫血具有良好的预期价值,曲线下面积为0.826(95%CI 0.742~0.909)。结论 慢性心力衰竭患者血浆中FGF-23和Gal-3水平与Hb呈显著负相关,血浆中FGF-23、Gal-3及尿素氮水平的增高是慢性心力衰竭患者贫血加重的危险因素。

Abstract:

Objective Anemia shows an important impact on the prognosis of heart failure patients. The main purpose of this study was to investigate the correlation of plasma fibroblast growth factor-23 (FGF-23) and galectin-3 (Gal-3) levels with anemia in patients with chronic heart failure. Methods The clinical data of 95 patients with acute attack of chronic heart failure admitted to our department from May 2018 to March 2019 were collected and analyzed retrospectively. According to being accompanied with anemia or not, these patients were divided into anemia group (n=47) and non-anemia group (n=48). The clinical data were compared between the 2 groups. The statistical analysis was carried out by SPSS statistics 25.0. Logistic regression analysis was used to analyze the effects of related factors on anemia. Receiver operating characteristic (ROC) curve was employed to predict the values of the related factors for anemia in heart failure patients. Results There were significant differences in hemoglobin (Hb), FGF-23, Gal-3, urea nitrogen, cystatin C and creatinine between the 2 groups (P<0.05). The Hb level was negatively correlated with FGF-23 (r=-0.470), Gal-3 (r=-0.379), urea nitrogen (r=-0.330), cystatin C (r=-0.319) and creatinine (r=-0.282, all P<0.01). Multivariate logistic regression analysis showed that FGF-23 (OR=1.02,5%CI 1.011-1.030), Gal-3(OR=1.05,5%CI 1.004-1.102) and urea nitrogen (OR=1.23,5%CI 1.030-1.481) were independent risk factors for anemia in patients with heart failure (P<0.05). ROC curve analysis indicated that FGF-23 had a good predictive value for anemia, and the area under the curve was 0.826(95%CI 0.742-0.909). Conclusion Plasma FGF-23 and Gal-3 levels are negatively correlated with Hb in patients with chronic heart failure. The elevations of plasma FGF-23, Gal-3 and urea nitrogen levels are risk factors for anemia in these patients.