锌指转录因子在冠心病心力衰竭气虚血瘀证患者血清中的表达及意义研究  

Study on Serum Expression and Significance of Zinc Finger Transcription Factor in Patients with Heart Failure in Coronary Heart Disease with Qi Deficiency and Blood Stasis Syndrome

作　　者：张蕾[1,2] 何建成[1] 李小茜[1] 沈琳[3] 曹雪滨[4] 王代明[5] ZHANG Lei;HE Jiancheng;LI Xiaoqian;SHEN Lin;CAO Xuebin;WANG Daiming(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;The First Affiliated Hospital(College of Clinical Medicine)of Henan University of Science and Technology,Luoyang Henan 471003,China;Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Chinese People's Liberation Army 252 Hospital,Baoding Hebei 071000,China;Shanghai Gonghui Hospital,Shanghai 201203,China)

机构地区：[1]上海中医药大学,上海201203 [2]河南科技大学第一附属医院(河南科技大学临床医学院),河南洛阳471003 [3]上海中医药大学附属龙华医院,上海201203 [4]中国人民解放军252医院,河北保定071000 [5]上海市公惠医院,上海201203

出　　处：《新中医》2023年第20期52-56,共5页New Chinese Medicine

基　　金：国家自然科学基金青年项目(81803996)

摘　　要：目的:研究锌指转录因子(GATA4)在冠心病心力衰竭(HF)气虚血瘀证患者血清中的表达及其与临床指标的相关性,初步拟定该证候的诊断界值。方法:收集冠心病HF气虚血瘀证患者及健康对照者各30例,酶联免疫吸附法(ELISA)检测血清中GATA4的含量。结果:GATA4在HF气虚血瘀证患者血清的含量为(5098.14±1446.98)pg/mL,明显高于健康对照组(2819.28±1022.74)pg/mL,差异有统计学意义(P<0.05);且随纽约心脏病协会(NYHA)心功能分级的增加,HF气虚血瘀证患者血清中GATA4含量不断升高,差异有统计学意义(P<0.05);HF气虚血瘀证患者血清GATA4与NYHA心功能分级呈正相关性(r=0.914,P<0.001),与B型钠尿肽(BNP)(r=0.697,P<0.001)呈正相关性,与左心室射血分数(LVEF)呈负相关性(r=-0.592,P=0.001)。绘制ROC曲线初步拟定血清清中GATA4诊断HF气滞血瘀证的界值为3777.49 pg/mL,曲线下面积为0.92。结论:GATA4能够反映HF病情轻重程度,可为HF气虚血瘀证提供客观化、量化的参考和依据。Objective:To study the expression of zinc finger transcription factor(GATA4)in the serum of patients with heart failure(HF)in coronary heart disease with qi deficiency and blood stasis syndrome and its correlation with clinical indexes,and to preliminarily formulate the diagnostic threshold for the syndrome.Methods:A total of 30 patients with HF in coronary heart disease with qi deficiency and blood stasis syndrome and 30 healthy people for control were collected.The enzyme-linked immunosorbent assay method(ELISA)was applied to detect the content of GATA4 in serum.Results:The content of GATA4 in serum of patients with HF with qi deficiency and blood stasis syndrome was 5098.14±1446.98 pg/mL,significantly higher than that of 2819.28±1022.74 pg/mL in the healthy control group,the difference being significant(P<0.05).With the increase of heart function grading by the New York Heart Association(NYHA),the serum GATA4 content in patients with HF with qi deficiency and blood stasis syndrome continues to increase,the difference being significant(P<0.05).Serum GATA4 was positively correlated with NYHA heart function grading(r=0.914,P<0.001),positively correlated with BNP(r=0.697,P<0.001),and negatively correlated with left ventricular ejection fraction(LVEF)in HF patients with qi deficiency and blood stasis syndrome(r=-0.592,P=0.001).The ROC was drawn to preliminarily draw the cut-off value of GATA4 in serum for diagnosing HF with qi stagnation and blood stasis syndrome,which was 3777.49 pg/mL,and the area under the curve is 0.92.Conclusion:GATA4 can reflect the severity of HF and provide objective and quantitative reference and basis for HF with qi deficiency and blood stasis syndrome.

关 键 词：心力衰竭 冠心病 气虚血瘀证 锌指转录因子 诊断界值 

分 类 号：R541.61[医药卫生—心血管疾病]