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目的探讨血清γ谷氨酰转移酶(gamma-glutamyl transferase,γ-GGT)对急性心力衰竭(acute heart failure,AHF)患者病死率的预测价值。方法将188例AHF患者分为死亡组和存活组,所有患者行生物化学以及血清γ-GGT浓度检测,分析两组患者的血清γ-GGT浓度及临床生化指标的差异。结果两组血清γ-GGT浓度、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、血尿素氮(blood urea nitrogen,BUN)、血肌酐(creatinine,Cr)、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme MB,CK-MB)、总胆汁酸(total bile acid,TBA)、心房脑钠肽(brain natriuretic peptide,BNP)浓度,射血分数(ejection fraction,EF)及合并原发性高血压(高血压)、心房纤颤患者比例比较,差异具有统计学意义(P<0.05)。应用Logistic回归分析显示,血清γ-GGT浓度为AHF患者的危险因素(P<0.05)。血清γ-GGT浓度对于AHF病死率的诊断的敏感度78.9%,特异度66.7%,受试者工作曲线下面积为0.759。结论血清γ-GGT浓度可能可以作为预测AHF的病死率的血清指标,具有一定的临床应用价值。
Objective To investigate the predictive value of serum gamma-glutamyl transferase (γ-GGT) in patients with acute heart failure (AHF). Methods 188 patients with AHF were divided into death group and survival group. All patients were examined for biochemistry and serum γ-GGT concentration. The difference of serum γ-GGT concentration and clinical biochemical indexes between the two groups were analyzed. Results The serum levels of γ-GGT, LDL-C, HDL-C, blood urea nitrogen , BUN, creatinine (Cr), creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB), total bile acid (TBA) The difference of the concentration of brain natriuretic peptide (BNP), ejection fraction (EF) and the proportion of patients with essential hypertension (hypertension) and atrial fibrillation was statistically significant (P <0.05 ). Logistic regression analysis showed that serum γ-GGT level was a risk factor for AHF (P <0.05). The sensitivity of serum γ-GGT for the diagnosis of AHF mortality was 78.9% and the specificity was 66.7%. The area under the working curve of the subjects was 0.759. Conclusion Serum γ-GGT concentration may be used as a serum index to predict the mortality of AHF, and has certain clinical value.