慢性心力衰竭血清Hcy、MIP-1α、SIRT1水平检测的价值研究  

Value of Detection of Serum Hcy,MIP-1αand SIRT1 Levels in Patients with Chronic Heart Failure

作　　者：拓步雄 徐杰 邹倩 彭利静 李慧 TUO Bu-xiong;XU Jie;ZOU Qian;PENG Li-jing;LI Hui(Department of Cardiology,the 986th Hospital of PLA Air Forces,Xi'an 710054,China)

机构地区：[1]中国人民解放军空军第九八六医院心血管内科,西安710054

出　　处：《解放军医药杂志》2020年第10期36-39,44,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家自然科学基金青年项目(81800360)。

摘　　要：目的探究慢性心力衰竭(CHF)患者血清同型半胱氨酸(Hcy)、巨噬细胞炎症蛋白1α(MIP-1α)、沉默信息调节因子2相关酶1(SIRT1)水平检测意义。方法选择2017年4月—2019年1月收治的CHF(研究组)118例及同期体检健康者(对照组)108例,检测血清Hcy、MIP-1α、SIRT1水平。比较纽约心脏病协会(NYHA)心功能分级Ⅱ级、Ⅲ级、Ⅳ级组以及对照组血清Hcy、MIP-1α、SIRT1水平,并分析其与心功能分级相关性,比较不同预后患者血清Hcy、MIP-1α、SIRT1水平,评估其对CHF预后不良预测价值。结果NYHAⅣ级组血清Hcy、MIP-1α水平均高于NYHAⅡ、Ⅲ级和对照组,且NYHAⅢ级高于NYHAⅡ级和对照组,NYHAⅡ级组高于对照组(P<0.01);NYHAⅣ级组血清SIRT1水平均低于NYHAⅡ、Ⅲ级组和对照组,且NYHAⅢ级组低于NYHAⅡ级和对照组,NYHAⅡ级组低于对照组(P<0.01)。心功能分级与Hcy、MIP-1α呈正相关(r=0.369、0.391,P<0.01),与SIRT1呈负相关(r=-0.382,P<0.01)。预后不良组Hcy、MIP-1α高于预后良好组,SIRT1低于预后良好组(P<0.05)。Hcy、MIP-1α、SIRT1预测CHF预后不良AUC值为0.808、0.871、0.856。结论血清Hcy、MIP-1α、SIRT1水平检测在评估CHF病情进展中发挥重要作用,于CHF诊疗有利。Objective To investigate the value of detection of serum homocysteine(Hcy),macrophage inflammatory protein 1α(MIP-1α)and silent information regulator factor 2 related enzyme 1(SIRT1)level in patients with chronic heart failure(CHF).Methods A total of 118 patients with CHF(research group)treated from April 2017 to January 2019 and 109 healthy physical examinees(control group)during the same period were selected as the research subjects.Serum Hcy,MIP-1αand SIRT1 levels were detected.The above indexes in New York Heart Disease Association(NYHA)classⅡgroup,classⅢgroup and classⅣgroup and the control group were compared,and their correlation with cardiac function classification was analyzed.Serum Hcy,MIP-1αand SIRT1 levels in patients with different prognosis were compared,and their predictive value for poor prognosis of CHF was analyzed.Results The levels of Hcy and MIP-1αwere the highest in NYHA classⅣgroup,followed by classⅢgroup,classⅡgroup,and control group(P<0.01).The level of SIRT1 was the lowest in NYHA classⅣgroup,followed by classⅢgroup,classⅡgroup,and control group(P<0.01).Cardiac function classification was positively correlated with Hcy and MIP-1α(r=0.369,0.391,P<0.01),but was negatively correlated with SIRT1(r=-0.382,P<0.01).Hcy and MIP-1αin poor prognosis group were significantly higher than those in good prognosis group,while SIRT1 was lower than that in good prognosis group(P<0.05).The AUC values of Hcy,MIP-1αand SIRT1 for predicting poor prognosis of CHF were 0.808,0.871 and 0.856 respectively.Conclusion Serum Hcy,MIP-1αand SIRT1 levels play an important role in assessing the progression of CHF,which are conductive to diagnosis and treatment of CHF.

关 键 词：慢性心力衰竭 同型半胱氨酸 巨噬细胞炎症蛋白1Α 沉默信息调节因子2相关酶1 心功能 预后 

分 类 号：R541.6[医药卫生—心血管疾病]