| 高 菲,马志玲,何佩娟,郭春棉,杨卫平.不同类型肥厚型心肌病患者临床特征及血清sST2、GGT表达差异性与心功能的相关性分析[J].,2023,(21):4042-4047 |
| 不同类型肥厚型心肌病患者临床特征及血清sST2、GGT表达差异性与心功能的相关性分析 |
| The Clinical Characteristics of Patients with Different Types of Hypertrophic Cardiomyopathy and the Correlation between Serum sST2, GGT Expression and Cardiac Function were Analyzed |
| 投稿时间：2023-07-10 修订日期：2023-07-31 |
| DOI：10.13241/j.cnki.pmb.2023.21.008 |
| 中文关键词: OHCM NOHCM 临床特征 sST2 GGT 心功能 |
| 英文关键词: OHCM nOHCM Clinical features sST2 GGT Cardiac function |
| 基金项目:陕西省自然科学基础研究计划项目（S2021-JC-YB-0259） |
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| 中文摘要: |
| 摘要 目的：分析不同类型肥厚型心肌病（HCM）患者临床特征及血清血清可溶性致癌抑制因子2（sST2）、γ-谷氨酰转移酶（GGT）表达差异性与心功能的相关性。方法：选取2020年1月～2023年1月本院收治的96例HCM患者作为研究对象，参照运动负荷试验左心室流出道与主动脉峰值压力阶差(LVOTG)测量结果将HCM患者分为OHCM组（44例）、NOHCM组（52例），并参照美国纽约心脏病协会(NYHA)心功能分级对两组患者的心功能进行分级；采用本院自制的调查表调查两组患者的临床特征，另采用酶联免疫吸附法检测血清sST2、GGT水平，通过双变量Spearman相关性检验分析血清sST2、GGT与心功能指标[左室舒张末期左心房容积（LAV）、左心室射血分数（LVEF）、左室舒张末期内径（LVD）、左房容积指数（LAVI）、E/E'、E/A、N端B型脑钠肽（NT-proBNP）、6 min步行距离（6MWD）]的相关性；另建立多因素Logistic模型，分析血清sST2、GGT对OHCM、NOHCM患者心功能的影响，同时分析血清sST2、GGT对OHCM、NOHCM患者不同心功能的预测价值。结果：与NYHAⅠ+Ⅱ级比较，OHCM、NOHCM组NYHA≥Ⅲ级sST2、GGT、LVD、LAV、LAVI、E/E'、NT-porBNP水平较高，LVEF、E/A水平较低，6MWD较短（P＜0.05）。OHCM组、NOHCM组与LVEF、E/A、6MWD呈负相关性，与LVD、LAV、LAVI、E/E'、NT-porBNP呈正相关性（P＜0.05）。多因素Logistic结果显示，血清sST2、GGT均是影响OHCM、NOHCM患者心功能的独立危险因素（P＜0.05）。血清sST2、GGT在OHCM、NOHCM患者NYHA≥Ⅲ级预测中的ACU均＞0.75。结论：血清sST2、GGT与不同类型HCM心功能存在一定关联，根据其表达水平变化情况可有效评估患者的心功能受损程度。 |
| 英文摘要: |
| ABSTRACT Objective: The clinical characteristics of patients with different types of hypertrophic cardiomyopathy (HCM) and the correlation between serum soluble oncogenic inhibitor 2 (sST2), γ-glutamyl transferase (GGT) expression and cardiac function were analyzed. Methods: A total of 96 patients with HCM admitted to our hospital from January 2020 to January 2023 were selected as the study objects. The HCM patients were divided into OHCM group (44 cases) and NOHCM group (52 cases) according to the measurement results of LVOTG between left ventricular outflow tract and aorta in exercise load test. The heart function of the two groups was graded according to the New York Heart Association (NYHA). The clinical characteristics of the two groups of patients were investigated by using a self-made questionnaire, and serum sST2 and GGT levels were detected by enzyme-linked immunosorbent assay. Serum sST2, GGT and cardiac function indexes [left ventricular end-diastolic left atrial volume (LAV), left ventricular ejection fraction (LVEF), left ventricular end-diastolic inner diameter (LVD), left atrial volume index (LAVI), E/E ', E/A, N-terminal B-type brain natriuretic peptide (NT-proBN) were analyzed by bivariate Spearman correlation test P), 6min walking distance (6MWD)]; In addition, multivariate Logistic model was established to analyze the effects of serum sST2 and GGT on cardiac function in patients with OHCM and NOHCM, and the predictive value of serum sST2 and GGT on different cardiac function in patients with OHCM and NOHCM. Results: Compared with NYHA I + II, the levels of sST2, GGT, LVD, LAV, LAVI, E / E ', NT-porBNP in OHCM and NOHCM groups with NYHA ≥ III were higher, the levels of LVEF and E / A were lower, and the 6MWD was shorter (P＜0.05). OHCM group and NOHCM group were negatively correlated with LVEF, E / A and 6MWD, and positively correlated with LVD, LAV, LAVI, E / E ' and NT-porBNP(P＜0.05). Multivariate Logistic results showed that serum sST2 and GGT were independent risk factors affecting cardiac function in patients with OHCM and NOHCM(P＜0.05). The ACU of serum sST2 and GGT in the prediction of NYHA ≥ III in OHCM and NOHCM patients was > 0.75. Conclusion: Serum sST2 and GGT are related to the cardiac function of different types of HCM, and the degree of cardiac function damage can be effectively evaluated according to the changes of their expression levels. |
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