血清SIRT1水平对慢性心力衰竭患者预后的预测价值分析  被引量:9

The value of serum SIRT1 level in predicting the prognosis of patients with chronic heart failure

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作  者:王宇栋[1] 罗卓卡[2] 蒋煜[1] 孙建辉[3] 刘欢年[1] Wang Yudong;Luo Zhuoka;Jiang Yu;Sun Jianhui;Liu Huannian(Internal Medicine-Cardiovascular Department,Changzhou Fourth People's Hospital,Changzhou,Jiangsu 213000)

机构地区:[1]常州市第四人民医院心血管内科,常州213000 [2]常州市第四人民医院药剂科,常州213000 [3]苏州大学附属第三医院心血管内科,常州213000

出  处:《中国循证心血管医学杂志》2019年第9期1073-1076,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基  金:江苏省药学会奥赛康医院药学科研项目(201411)

摘  要:目的探讨血清沉默信息调节因子2相关酶1(SIRT1)水平对慢性心力衰竭(CHF)患者预后的预测价值。方法选取2013年1月~2016年6月于常州市第四人民医院心血管内科收治的97例CHF患者为CHF组,CHF组根据NYHA分级分为Ⅱ级(n=41),Ⅲ级(n=34),Ⅳ级(n=22),另选取同期于我院体检的健康志愿者40例为对照组(n=40),采用酶联免疫吸附试验检测所有研究对象血清SIRT1、N末端B型钠尿肽原(NT-proBNP)水平;采用彩色超声多普勒检测仪检查受试者左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD);比较对照组及CHF组不同分级的CHF患者的血清SIRT1、NT-proBNP水平及LVEF、LVEDD情况;采用Peason相关性分析SIRT1与LVEF、LVEDD及NT-proBNP的相关性;随访2年,采用受试者工作特征(ROC)曲线分析SIRT1对患者预后的预测价值。结果CHF患者血清SIRT1水平、LVEF均低于对照组,且随着NYHA分级的增加,SIRT1水平、LVEF呈下降趋势,组间比较差异均有统计学意义(P<0.05);而CHF患者NT-proBNP、LVEDD均高于对照组,且随着NYHA分级的增加,NT-proBNP、LVEDD呈上升趋势,组间比较差异有统计学意义(P<0.05)。Peason相关性分析显示,CHF患者SIRT1与LVEF呈正相关关系,与NT-proBNP、LVEDD呈负相关关系(P<0.05)。随访结果表明,2年内因CHF死亡人数为32例,其中存活者平均血清SIRT1为(1160.72±96.39)pg/ml,死亡者平均血清SIRT1为(598.24±114.58)pg/ml,两者比较差异有统计学意义(P<0.05)。ROC曲线分析显示,血清SIRT1的曲线下面积为0.755,此时其预测患者死亡的敏感度、特异性分别为73.8%、70.0%。结论CHF患者血清SIRT1水平明显降低,且心功能越差,SIRT1水平降低越明显,血清SIRT1水平对CHF患者预后具有较高的预测价值。Objective To investigate the predictive value of serum sirtuin-2 related enzyme 1(SIRT1)level in patients with chronic heart failure(CHF).Methods From January 2013 to June 2016,97 patients with CHF were enrolled in the CHF group.According to NYHA classification,CHF group was divided into gradeⅡ(41 cases),gradeⅢ(34 cases)and gradeⅣ(22 cases).Another 40 healthy volunteers who underwent physical examination were selected as control group.The levels of SIRT1 and N-terminal B-type natriuretic peptide(NT-proBNP)in all subjects was detected by Enzyme-linked immunosorbent assay.Left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)was measured by color Doppler echocardiography.The SIRT1,NTproBNP,LVEF and LVEDD of control group and CHF group and CHF patients with different NYHA grades was compared.Pearson correlation analysis was used to analyze the correlation between SIRT1 and,LVEF,LVEDD and NT-proBNP,follow up for 2 years,ROC curve was used to analyze the value of SIRT1 in predicting the prognosis of CHF patients.Results The level of serum SIRT1 and LVEF in CHF patients were lower than those in the control group,and with the increase of NYHA grades,the level of SIRT1 and LVEF showed a downward trend,with significant differences between groups(P<0.05).NT-proBNP and LVEDD of CHF patients were higher than those of the control group.With the increase of NYHA classification,NT-proBNP and LVEDD showed an upward trend,and the difference between the two groups was statistically significant(P<0.05).Pearson correlation analysis showed that there was a positive correlation between SIRT1 and LVEF in CHF patients,and negatively correlated with NT-proBNP and LVEDD(P<0.05).The follow-up results showed that 32 patients died of CHF within 2 years.The average serum SIRT1 of survivors was(1160.72±96.39)pg/ml,and that of the dead was(598.24±114.58)pg/ml,with a significant difference(P<0.05).ROC curve analysis showed that the area under the curve of serum SIRT1 was 0.755,At this time,the sensitiv

关 键 词:沉默信息调节因子2相关酶1 慢性心力衰竭 预后 预测价值 

分 类 号:R541.61[医药卫生—心血管疾病]

 

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