2026 年第 10 期 第 21 卷

和肽素与集落刺激因子2受体β亚基联合CHA2DS2-VASc评分对急性心肌梗死患者合并心力衰竭严重程度的诊断价值分析

Diagnostic value of copeptin, colony-stimulating factor 2 receptor β-subunit combined with CHA2DS2-VASc score for the severity of heart failure in patients with acute myocardial infarction

作者：高宁张杏嫣王景蕊张慧晶

英文作者：Gao Ning Zhang Xingyan Wang Jingrui Zhang Huijing

单位：哈励逊国际和平医院（河北省衡水市人民医院）心血管内科，衡水053000

英文单位：Department of Cardiovascular Medicine Harrison International Peace Hospital (Hengshui People′s Hospital Hebei Province) Hengshui 053000 China

关键词：急性心肌梗死；和肽素；集落刺激因子2受体β亚基；CHA2DS2-VASc评分；心力衰竭严重程度；诊断价值

英文关键词：Acutemyocardialinfarction;Copeptin;Colony-stimulatingfactor2receptorβ-subunit;CHA2DS2-VAScscore;Heartfailureseverity;Diagnosticvalue

• 摘要：

• 目的  探究和肽素与集落刺激因子2受体β亚基（CSF2RB）联合CHA2DS2-VASc评分对急性心肌梗死（AMI）患者合并心力衰竭严重程度的诊断价值。方法 回顾性选取2024年4月至2026年4月哈励逊国际和平医院心血管内科收治的150例AMI患者作为研究对象。根据Killip分级标准将患者分为轻度组（68例）和中重度组（82例）。收集一般资料，检测和肽素、CSF2RB水平，并进行CHA2DS2-VASc评分，分析和肽素、CSF2RB水平联合CHA2DS2-VASc评分对AMI患者严重程度的诊断价值。结果 2组患者肌钙蛋白、肌酸激酶同工酶、C反应蛋白、总胆固醇水平、梗死类型、冠状动脉病变支数比例比较差异均有统计学意义（均P＜0.05）。中重度组和肽素、CSF2RB水平和CHA2DS2-VASc评分均高于轻度组［（166±27）ng/L比（88±16）ng/L、（9.1±2.1）μg/L比（3.7±0.8）μg/L、4（4,5）分比2（1,2）分］，差异均有统计学意义（t=22.470、20.560、Z=9.466，均P＜0.001）。血清和肽素、CSF2RB水平、CHA2DS2-VASc评分均与心功能Killip分级呈显著正相关（r=0.728、0.765、0.746，均P＜0.001）。多因素Logistic回归分析结果显示，和肽素、CSF2RB水平、CHA2DS2-VASc评分均是影响AMI患者病情进展的独立危险因素（均P＜0.05）。和肽素、CSF2RB水平、CHA2DS2-VASc评分检测的曲线下面积分别为0.750、0.757、0.771，三者联合为0.865。结论 和肽素、CSF2RB水平联合CHA2DS2-VASc评分对AMI患者合并心力衰竭严重程度的诊断价值优于单一检测，可为AMI患者合并心力衰竭严重程度的临床诊断提供可靠参考依据。

• Objective To explore the diagnostic value of copeptin and colony-stimulating factor 2 receptor β-subunit (CSF2RB) combined with CHA2DS2-VASc score for the severity of heart failure in patients with acute myocardial infarction (AMI). Methods A total of 150 patients with AMI admitted to Department of Cardiovascular Medicine, Harrison International Peace Hospital from April 2024 to April 2026 were retrospectively enrolled as research subjects. Patients were divided into mild group (68 cases) and moderate-severe group (82 cases) according to the Killip classification criteria. General data were collected, serum levels of copeptin and CSF2RB were detected, and CHA2DS2-VASc scores were assessed. The diagnostic value of copeptin combined with CSF2RB and CHA2DS2-VASc score for disease severity in AMI patients was analyzed. Results There were statistically significant differences in troponin, creatine kinase-MB isoenzyme, C-reactive protein, total cholesterol, infarction type and proportion of coronary lesion vessel number between the two groups (all P＜0.05). The levels of copeptin, CSF2RB and CHA2DS2-VASc score in the moderate-severe group were higher than those in the mild group ［(166±27)ng/L vs (88±16)ng/L, (9.1±2.1)μg/L vs (3.7±0.8)μg/L, 4(4,5) vs 2(1,2)］(t=22.470, 20.560, Z=9.466, all P＜0.001). Serum copeptin, CSF2RB levels and CHA2DS2-VASc score were significantly positively correlated with Killip classification of cardiac function (r=0.728, 0.765, 0.746, all P＜0.001). Multivariate Logistic regression analysis showed that copeptin, CSF2RB levels and CHA2DS2-VASc score were independent risk factors for disease progression in AMI patients (all P＜0.05). The area under the receiver operating characteristic curve of copeptin, CSF2RB and CHA2DS2-VASc score were 0.750, 0.757 and 0.771 respectively, and the value of their combination was 0.865. Conclusion The combined detection of copeptin, CSF2RB and CHA2DS2-VASc score is superior to single indicator detection in diagnosing the severity of heart failure in AMI patients, which can provide reliable reference for clinical diagnosis of heart failure severity in AMI patients.