HIF-1α、VEGF及TIMP与心脏瓣膜置换术后并发压力性损伤的相关性研究  

Correlation between HIF-1α,VEGF,TIMP and pressure injury after heart valve replacement

作　　者：申荣华[1] 谢静 刘燕[3] 李秀莉[4] 封俊艳 SHEN Ronghua;XIE Jing;LIU Yan;LI Xiuli;FENG Junyan(Department of Cardiology,the First Hospital of Hebei Medical University,Shijiazhuang,Hebei,China,050031;Department of Cardiothoracic Surgery,Chengde Central Hospital,Chengde,Hebei,China,050000;Department of Cardiothoracic Surgery,the First Hospital of Hebei Medical University,Shijiazhuang,Hebei,China,050031;Department of Nursing,the First Hospital of Hebei Medical University,Shijiazhuang,Hebei,China,050031)

机构地区：[1]河北医科大学第一医院心外科监护室,河北石家庄050031 [2]承德市中心医院心胸外科,河北承德050000 [3]河北医科大学第一医院心胸外科,河北石家庄050031 [4]河北医科大学第一医院护理部,河北石家庄050031

出　　处：《分子诊断与治疗杂志》2020年第10期1367-1370,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省2018年度医学科学研究重点课题计划(20180253)。

摘　　要：目的研究缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)及组织金属蛋白酶抑制剂(TIMP)与心脏瓣膜置换术后并发压力性损伤的相关性。方法选取2019年2月至2020年1月本院ICU收治的161例心脏瓣膜置换术后患者作为研究对象。将患者根据是否并发压力性损伤分为并发压力性损伤者54(33.54%)以及未并发压力性损伤者未并发者107(66.46%)。比较患者HIF-1α、VEGF、TIMP表达水平及与压力性损伤分期的相关性;计算HIF-1α、VEGF及TIMP单独检测和联合检测对术后压力性损伤预测的敏感性、特异性、准确性。结果并发压力损伤者HIF-1α、VEGF及TIMP水平均显著高于未并发压力损伤者,差异具有统计学意义(P<0.05);1、2期压力性损伤者HIF-1α、VEGF及TIMP水平明显高于3、4期,差异具有统计学意义(P<0.05),分期越高损伤越严重,其HIF-1α、VEGF及TIMP水平表达越高,上述因子与压力性损伤分期程度呈明显正相关(P<0.05);HIF-1α、VEGF及TIMP联合检测预测术后压力性损伤灵敏度、特异度及准确度显著高于单一检测。结论HIF-1α、VEGF及TIMP与心脏瓣膜置换术后并发压力性损伤具有一定相关性,上述因子联合监测可有效预测压力性损伤。Objective To study the correlation between hypoxia inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),and tissue inhibitor of matrix metalloproteinases(TIMP)and pressure injury after heart valve replacement.Methods 161 patients after heart valve replacement in our hospital from February 2019 to January 2020 were selected.The levels of HIF-1α,VEGF,TIMP and their correlation with the stage of pressure injury were compared in different patients.The sensitivity,specificity,and accuracy of HIF-1α,VEGF,and TIMP alone and combined detection for the prediction of postoperative pressure injury were calculated.Results The levels of HIF-1α,VEGF and TIMP in patients with pressure injury were significantly higher than those of patients without pressure injury,and the difference was statistically significant(P<0.05).The levels of HIF-1α,VEGF and TIMP in patients with stages 1 and 2 pressure injury were significantly higher than those with stages 3 and 4,and the difference was statistically significant(P<0.05).The higher the stage,the more severe the injury,and the higher the expression of HIF-1α,VEGF and TIMP.The above factors are significantly positively correlated with the stage of pressure injury(P<0.05);The sensitivity,specificity and accuracy of combined detection of HIF-1α,VEGF and TIMP for predicting postoperative pressure injury were significantly higher than that of single detection.Conclusion HIF-1α,VEGF and TIMP have a certain correlation with pressure injury after heart valve replacement.Combined monitoring of these three factors can effectively predict pressure injury.

关 键 词：缺氧诱导因子-1Α 血管内皮生长因子 组织金属蛋白酶抑制剂 压力性损伤 

分 类 号：R654.2[医药卫生—外科学]