文章摘要
夏海亭,路长鸿,杨 侃,孙庆楠,王 恺.血清SIRT1水平与射血分数保留的心力衰竭患者炎性因子、氧化应激的相关性分析及对预后的影响研究[J].,2023,(2):356-360
血清SIRT1水平与射血分数保留的心力衰竭患者炎性因子、氧化应激的相关性分析及对预后的影响研究
Correlation Analysis of Serum SIRT1 Level with Inflammatory Factors and Oxidative Stress in Patients with Heart Failure with Preserved Ejection Fraction and its Influence Study on Prognosis
投稿时间:2022-05-26  修订日期:2022-06-22
DOI:10.13241/j.cnki.pmb.2023.02.029
中文关键词: 去乙酰化酶1  射血分数保留的心力衰竭  炎症因子  氧化应激  预后
英文关键词: SIRT1  Heart failure with preserved ejection fraction  Inflammatory factors  Oxidative stress  Prognosis
基金项目:山东省医药卫生科技发展计划项目(202010000131)
作者单位E-mail
夏海亭 青岛大学医学部 山东 青岛 266071 xia5181998@163.com 
路长鸿 青岛阜外心血管病医院心内科 山东 青岛 266034  
杨 侃 青岛大学医学部 山东 青岛 266071  
孙庆楠 淄博市淄川区医院心内科 山东 淄博 255199  
王 恺 淄博市中心医院重症医学科 山东 淄博 255020  
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中文摘要:
      摘要 目的:探讨血清去乙酰化酶1(SIRT1) 水平与射血分数保留的心力衰竭(HFpEF)患者炎性因子、氧化应激的相关性,分析SIRT1预测HFpEF患者预后的价值。方法:选择2019年10月至2021年6月青岛阜外心血管病医院收治的190例HFpEF患者为HFpEF组,92例心功能正常的健康体检志愿者为对照组。HFpEF患者出院后随访12个月,统计随访期间不良心血管事件发生情况,多因素Logistic回归分析HFpEF患者预后不良的影响因素。结果:HFpEF组血清SIRT1水平低于对照组(P<0.05),白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、丙二醛(MDA)、晚期氧化蛋白产物(AOPP)水平高于对照组(P<0.05)。HFpEF患者血清SIRT1水平与IL-6、TNF-α、CRP、MDA、AOPP呈负相关(r=-0.496、-0.502、-0.419、-0.533、-0.542,P<0.05)。190例患者2例失访,余188例HFpEF患者中41例预后不良,147例预后良好。预后不良组美国纽约心脏病协会(NYHA)Ⅳ级比例、IL-6、TNF-α、CRP、MDA、AOPP、N末端B型利钠肽前体(NT-proBNP)水平、左室收缩末期内径(LVEDS)、左室舒张末期内径(LVEDD)、二尖瓣舒张早期血流峰值(E)与舒张晚期血流峰值(A)(E/A)高于预后良好组(P<0.05),血清SIRT1水平、左心室射血分数(LVEF)低于预后良好组(P<0.05)。高IL-6、高MDA、高NT-proBNP是HFpEF患者预后不良的危险因素(P<0.05),SIRT1是HFpEF患者预后不良的保护因素(P<0.05)。结论:HFpEF患者血清SIRT1水平降低,与HFpEF患者炎症反应、氧化应激以及预后不良的发生有关,可作为HFpEF患者预后评估的辅助指标。
英文摘要:
      ABSTRACT Objective: To investigate the correlation between serum Sirtuin 1 (SIRT1) level and inflammatory factors and oxidative stress in patients with heart failure with preserved ejection fraction (HFpEF), and to analyze the prognostic value of SIRT1 in patients with HFpEF. Methods: 190 patients with HFpEF who were admitted to Qingdao Fuwai Cardiovascular Hospital from October 2019 to June 2021 were selected as HFpEF group, and 92 healthy examination volunteers with normal cardiac function were selected as control group. The patients with HFpEF were followed up for 12 months after discharge. The incidence of adverse cardiovascular events during the follow-up period was statistically analyzed. Multivariate Logistic regression analysis was used to analyze the influencing factors of poor prognosis in patients with HFpEF. Results: The serum SIRT1 level in the HFpEF group was lower than that in the control group (P<0.05), and the interleukin (IL) -6, tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), malondialdehyde (MDA) and advanced oxidation protein product (AOPP) levels were higher than those in control group(P<0.05). Serum SIRT1 level in patients with HFpEF were negatively correlated with IL-6, TNF-α, CRP, MDA and AOPP(r=-0.496, -0.502, -0.419, -0.533, -0.542, P<0.05). 2 cases of the 190 patients were lost to follow-up. Among the remaining 188 patients with HFpEF, 41 had poor prognosis, and 147 had good prognosis. New York Heart Association(NYHA) grade Ⅳ ratio, IL-6, TNF-α, CRP, MDA, AOPP, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, left ventricular end-systolic diameter (LVEDS), left ventricular end-diastolic diameter (LVEDD), mitral valve early diastolic Peak Flow (E) and Late diastolic Peak Flow (A) (E/A) in the poor prognosis group were higher than those in the good prognosis group(P<0.05), and the serum SIRT1 level and left ventricular ejection fraction(LVEF) were lower than those in the good prognosis group(P<0.05). High IL-6, high MDA and high NT-proBNP were risk factors for poor prognosis in patients with HFpEF(P<0.05), and SIRT1 was a protective factor for poor prognosis in patients with HFpEF(P<0.05). Conclusion: The decrease serum SIRT1 level in patients with HFpEF is related to the occurrence of inflammatory reaction, oxidative stress and poor prognosis in patients with HFpEF, which can be used as an auxiliary indicator for the prognosis evaluation of patients with HFpEF.
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