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目的 探讨血清心肌损伤相关指标、半乳糖凝集素-3(Gal-3)和生长分化因子-15(GDF-15)与病毒性心肌炎(VMC)患者6个月预后的关系。方法 纳入山西省汾阳医院2023年6月-2024年6月收治的病毒性心肌炎(Viral myocarditis,VMC)患者120例及同期健康体检者60例，比较两组血清指标。根据6个月随访结局将VMC患者分为预后良好组(n=82)和预后不良组(n=38)，采用多因素Logistic回归构建列线图，并采用Bootstrap重采样进行内部验证，以受试者工作特征(ROC)曲线、校准曲线和决策曲线分析评估模型表现。结果 VMC组的ALT、AST、LDH、cTnI、CK-MB、CK、Gal-3和GDF-15水平均高于对照组，预后不良组上述指标均高于预后良好组(P<0.05)。多因素分析显示，上述指标均与不良预后独立相关。联合模型的曲线下面积为0.944(95%CI:0.896～0.991);Hosmer-Lemeshow检验χ2=7.968,P=0.437。结论 VMC患者的上述血清指标与6个月不良预后独立相关；联合模型在本研究样本中显示出较好的区分能力，但仍需外部验证。
Abstract：Objective To investigate the associations of serum myocardial injury-related indicators, galectin-3(Gal-3), and growth differentiation factor-15(GDF-15) with 6-month outcomes in patients with viral myocarditis(VMC). Methods A total of 120 patients with VMC admitted to Fenyang Hospital from June 2023 to June 2024 and 60 healthy individuals were included. Serum indicators were compared between the groups. According to 6-month outcomes, patients were classified into a good-prognosis group(n=82) and a poor-prognosis group(n=38). Multivariable logistic regression was used to construct a nomogram, with bootstrap resampling for internal validation. Model performance was examined using receiver operating characteristic(ROC), calibration, and decision curves. Results Levels of ALT, AST, LDH, cTnI, CKMB, CK, Gal-3, and GDF-15 were higher in the VMC group than in the control group and higher in the poorprognosis group than in the good-prognosis group(all P<0.05). All eight indicators were independently associated with poor prognosis. The combined model had an area under the ROC curve of 0.944(95%CI: 0.896-0.991). The Hosmer-Lemeshow test yielded χ2 =7.968 and P=0.437. Conclusion These serum indicators were independently associated with 6-month poor prognosis in patients with VMC. The combined model showed good discrimination in this sample but requires external validation.
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基本信息:
中图分类号:R542.21
引用信息:
[1]邢爱华,裴文娟,徐涛.血清标志物与病毒性心肌炎患者预后的关系[J].病毒学报().
基金信息:
山西医科大学汾阳学院科研项目(项目号:2025A11),题目:转录组学与代谢组学联合分析动脉粥样硬化进展为心肌梗死的生物标志物研究
2026-09-05
2026-09-05
2026-09-05