退行性心脏瓣膜病患者血清骨桥蛋白水平、血浆B型利钠肽水平与心功能的关系  

Relationships Between Blood Levels of Osteopontin,Brain Natriuretic Peptide and Cardiac Function in Patients With Degenerative Heart Valve Disease

作　　者：李春芝[1] 李素彦[1] 刘琼[1] 牛占丛 

机构地区：[1]河北省人民医院感染性疾病科,石家庄市050051

出　　处：《中国循环杂志》2016年第5期459-462,共4页Chinese Circulation Journal

摘　　要：目的:探讨退行性心脏瓣膜病(DHVD)患者血清骨桥蛋白水平、血浆B型利钠肽(BNP)水平与心功能的关系。方法:随机选取2013-12至2015-02我院收治的DHVD 120例为DHVD组,另选取30例同期健康查体者为健康组。采用酶联免疫吸附法(ELISA)检测两组受检者血清骨桥蛋白水平,并依此将DHVD组分为正常水平亚组(18.8ng/ml≤血清骨桥蛋白水平≤30.0 ng/ml,n=35)和高水平亚组(血清骨桥蛋白水平>30.0 ng/ml,n=85)。比较健康组和DHVD组治疗前、治疗3 d、治疗1周和治疗2周的血清骨桥蛋白水平、血浆BNP水平和心排出量、心脏指数、左心室射血分数(LVEF)等心功能指标,并采用Pearson线性相关分析法分析DHVD患者血清骨桥蛋白水平、血浆BNP水平与心功能的关系。结果:与健康组治疗前比较,高水平亚组的血清骨桥蛋白水平和血浆BNP水平均升高,心排出量、心脏指数、左心室射血分数指标均降低。与正常水平亚组比较,高水平亚组治疗前、治疗3 d、治疗1周和治疗2周的血清骨桥蛋白水平和血浆BNP水平均较高,心排出量、心脏指数、左心室射血分数则较低。与本组治疗前比较,DHVD组治疗1周和治疗2周的血清骨桥蛋白水平和血浆BNP水平均降低,心排出量、心脏指数、左心室射血分数则较高。差异均有统计学意义(P<0.05)。Pearson线性相关分析法分析结果显示,DHVD患者血清骨桥蛋白水平与其血浆BNP水平呈正相关(r=0.936,P=0.00),与其心排出量、心脏指数、左心室射血分数则均呈负相关(r=-0.869,-0.884,-0.858;P均=0.00)。结论:DHVD患者血清骨桥蛋白水平较高且与其血浆BNP水平和心功能均相关,这可能与骨桥蛋白促进心脏瓣膜钙化、炎症反应及心肌损伤等相关,血清骨桥蛋白可用于DHVD患者病情和心功能评估的辅助参考指标。Objective：To explore the relationships between blood levels of osteopontin（OPN）, brain natriuretic peptide（BNP） and cardiac function in patient with degenerative heart valve disease（DHVD）. Methods： Our research included in 2 groups： DHVD group, n =120 relevant patients treated in our hospital from 2013-12 to 2015-02 and Control group, n =30 healthy subjects from physical examination in the same period of time. Based on blood levels of OPN, DHVD patients were further divided into 2 sub-groups as Normal OPN sub-group, the patients with 18.8 ng/ml ≤OPN≤ 30.0 ng/ml, n=35 and High OPN sub-group, the patients with OPN30.0 ng/ml, n=85. OPN levels at prior treatment（T0） and 3 days（T1）, 1 week（T2）, 2 weeks（T3） after treatment were compared between DHVD group and Control group; BNP levels, cardiac outcome（CO）, cardiac index（CI） and left ventricular ejection fraction（LVEF） were also compared. The relationships between blood levels of OPN, BNP and cardiac function in DHVD patients were studied by Pearson correlation analysis. Results： Compared with Control group at T0 time point, High OPN sub-group showed increased blood levels of OPN and BNP, while decreased CO, CI and LVEF. Compared with Normal OPN sub-group, High OPN sub-group had the higher levels of OPN and BNP at all 4 time points, while lower levels of CO, CI and LVEF. In DHVD group, compared with T0 time point,OPN and BNP levels were decreased at T2 and T3 time points, while CO, CI and LVEF were increased, all P〈0.05. Pearson correlation analysis presented that in DHVD patients, blood levels of OPN were positively related to BNP（r=0.936, P=0.00） and negatively related to CO, CI and LVEF（r=-0.869, r=-0.884 and r=-0.858 respectively, all P=0.00）.Conclusion： DHVD patients had increased blood level of OPN which is related to BNP level and cardiac function; this might be because of OPN promoting heart valve calcification, inflammatory reaction and myocardial injury. OPN could be used as a reference index for

关 键 词：心脏瓣膜疾病 骨桥蛋白 利钠钛 脑 心脏功能试验 

分 类 号：R541[医药卫生—心血管疾病]