热休克蛋白70-hom基因+2437 T/C位点基因多态性与慢性心力衰竭患者预后的关系研究  

Relationship between Hom Gene +2437 T/C Polymorphism of Heat Shock Protein 70 and Prognosis in Patients with Chronic Cardiac Failure

作　　者：张伟[1] 宋小英[1] 李芸[2] ZHANG Wei;SONG Xiao-ying;LI Yun(Department of Cardiology,Dongguan Branch of the Affiliated Hospital of Yan＇an University,Yan＇an 716000,China;Department of Electrophysiology,Dongguan Branch of the Affiliated Hospital of Yan＇an University,Yan＇an 716000,China)

机构地区：[1]延安大学附属医院东关分院心内科,陕西省延安市716000 [2]延安大学附属医院东关分院心电生理科,陕西省延安市716000

出　　处：《实用心脑肺血管病杂志》2018年第8期27-31,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：陕西省卫计委科技计划项目(2016D065)

摘　　要：目的探讨热休克蛋白(HSP)70-hom基因+2437 T/C位点基因多态性与慢性心力衰竭(CHF)患者预后的关系。方法选取2013年1月—2015年7月延安大学附属医院东关分院心内科收治的CHF患者366例,随访2年,按照随访结果分为预后不良组90例和预后良好组276例。比较不同基因型患者血清HSP70水平及不同预后患者临床特征、基因型、等位基因分布频率;基因型与CHF患者预后的关系分析采用多因素Logistic回归分析。结果 (1)本组患者中T/T基因型者236例(占64.5%)、T/C基因型者115例(占31.4%)、C/C基因型者15例(占4.1%),基因型分布符合Hardy-Weinberg遗传平衡(P>0.05)。(2)不同基因型患者血清HSP70水平比较,差异无统计学意义(P>0.05)。(3)预后良好组和预后不良组患者男性比例、体质指数、冠心病发生率、高血压发生率、糖尿病发生率、吸烟率、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)比较,差异无统计学意义(P>0.05);预后不良组患者年龄大于预后良好组,脑钠肽(BNP)、纽约心脏病协会(NYHA)分级Ⅲ~Ⅳ级者所占比例及左心室射血分数(LVEF)高于预后良好组,左心室舒张末期内径(LVEDD)、右心室舒张末期内径(RVEDD)长于预后良好组(P<0.05)。(4)预后良好组和预后不良组患者基因型比较,差异有统计学意义(P<0.05);而等位基因分布频率比较,差异无统计学意义(P>0.05)。(5)多因素Logistic回归分析结果显示,基因型是CHF患者预后的独立影响因素[OR=1.412,95%CI(1.107,1.801),P<0.05]。结论 HSP70-hom基因+2437 T/C位点基因多态性与CHF患者预后有关,C/C基因型可能增加CHF患者预后不良发生风险。ObjectiveTo explore the relationship between hom gene ＋2437 T/C polymorphism of heat shock protein70（HSP70）and prognosis in patients with chronic cardiac failure（CHF）. MethodsFrom January 2013 to July 2015,a toatl of 366 patients with CHF were selected in the Department of Cardiology,Dongguan Branch of the Affiliated Hospital of Yan＇an University,and they were divided into A group（with poor prognosis,n=90）and B group（with good prognosis,n=276）according to the 2-year follow-up. Serum HSP70 level was compared in patients with different genetypes,clinical features,genetypes and allelic frequency were compared between A group and B group;relationship between genetypes and prognosis in patients with CHF was analyzed by multivariate Logistic regression analysis. Results（1）Of the 366 patients,236 cases were T/T genetype（accounting for 64.5%）,115 cases were T/C genetype（accounting for 31.4%）,15 cases were C/C genetype（accounting for 4.1%）,the genetype distribution was accord with Hardy-Weinberg genetic equilibrium（P〉0.05）.（2）No statistically significant differences of serum HSP70 level was found in patients with different genetypes（P〉0.05）.（3）No statistically significant differences of male proportion,BMI,incidence of coronary heart disease,hypertension or diabetes,smoking rate,TG or LDL-C was found between A group and B group（P〉0.05）;agein A group was statistically significantly older than that in B group,BNP and proportion of patients with Ⅲ - to Ⅳ - grade NYHA classification in A group were statistically significantly higher than those in B group,LVEDD and RVEDD in A group were statistically significantly longer than that in B group（P〈0.05）.（4）There were statistically significant differences of genetypes between A group and B group（P〈0.05）,while no statistically significant differences of allelic frequency was found between A group and B group（P〉0.05）.（5）Multivariate Logistic regression

关 键 词：心力衰竭 热休克蛋白质70 多态性 单核苷酸 预后 

分 类 号：R541.6[医药卫生—心血管疾病]