血浆可溶性晚期糖基化终末产物受体在妊娠期高血压性心脏病的表达及其临床意义  

Expression and Clinical Meaning of Plasma Soluble Receptor of Advanced Glycation End Product in Patients With Gestational Hypertension Heart Disease

作　　者：左坤[1] 陈德 王梅[1] 景军宁[1] 杜松[1] 刘青[1] 

机构地区：[1]甘肃省妇幼保健院急诊科,兰州市730050

出　　处：《中国循环杂志》2017年第9期913-916,共4页Chinese Circulation Journal

摘　　要：目的:探讨可溶性晚期糖基化终末产物受体(s RAGE)在妊娠期高血压性心脏病中的表达和临床意义。方法:选择2013-06至2016-07我院收治的57例符合妊娠期高血压性心脏病诊断标准的患者作为观察组,并收集同期正常妊娠患者57例作为对照组;将观察组患者根据纽约心脏协会(NHYA)心功能Ⅰ~Ⅳ级又分为四个亚组,根据28 d生存与否分为存活组(n=49)和死亡组(n=8)两个亚组。采用酶联免疫吸附法(ELISA)检测患者入院24 h内血浆s RAGE,同时进行B型利钠肽(BNP)水平测定。比较各组间患者s RAGE水平变化差异及分析s RAGE对妊娠期高血压性心脏病患者预后的判断价值。结果:观察组患者血浆s RAGE浓度显著高于对照组[(939.2±184.3)pg/ml vs(467.3±116.2)pg/ml,P<0.05];观察组患者血浆s RAGE水平与NYHA心功能分级呈正相关关系(r=0.76,P<0.001),随着心功能分级增加,血浆s RAGE浓度亦呈升高趋势(P<0.05);观察组患者中死亡组的血浆s RAGE浓度明显高于生存组[(1647.6±249.7)pg/ml vs(776.9±146.2)pg/ml,P<0.05];s RAGE和BNP诊断妊娠期高血压性心脏病的受试者操作特征曲线下面积分别为0.91和0.88,差异有统计学意义(P<0.05)。结论:妊娠期高血压性心脏病患者血浆s RAGE水平升高,血浆s RAGE水平与心力衰竭严重程度相关,可作为患者预后的早期预测指标。Objective： To explore the expression and clinical meaning of plasma soluble receptor of advanced glycation end product （sRAGE） in patients with gestational hypertension heart disease. Methods： Our research included in 2 groups： Observation group, n=57 patients with gestational hypertension heart disease who were diagnosed and treated in our hospital from 2013-06 to 2016-07; Control group, n=57 healthy pregnant women at the same period of time. Based on cardiac function, the patients in Observation group was divided into 4 subgroups as NYH I, II, III and IV; according to 28-day surviving, the patients were divided into another set of 2 subgroups as Survival subgroup, n=49 and Death subgroup, n=8. Plasma levels of sRAGE and BNP were examined within 24h of admission. The changes of sRAGE were compared among different groups and the impact of sRAGE on gestational hypertension heart disease prognosis was analyzed. Results： Compared with Control group, Observation group had increased plasma sRAGE （939.2±184.3） pg/mL vs （467.3±116.2） pg/mL, P〈0.05; sRAGE level was positively related to NYHA grading （r=0.76, P〈0.001）, sRAGE had an elevating trend upon NYI-IA grade increasing accordingly, P〈0.05. Compared with Survival subgroup, Death subgroup had increased plasma sRAGE （1647.6±249.7） pg/mL vs （776.9±146.2） pg/mL, P〈0.05. The areas of sRAGE and BNP under ROCcurve were 0.91 and 0.88 respectively, P〈0.05. Conclusion： Plasma sRAGE was increased in patients with gestational hypertension heart disease; it was related to severity of heart failure （HF） and could be used for predicting the early prognosis in HF patients.

关 键 词：高血压 妊娠性 糖基化终产物 高级 利钠肽 脑 

分 类 号：R54[医药卫生—心血管疾病]