高血压性心脏病患者血清血小板反应蛋白1、尿素氮水平及其与预后相关性  

The level of serum thrombospondin 1,urea nitrogen and its correlation with prognosis in patients with hypertensive heart disease

作　　者：侯培培[1] 于倩[1] 矫妮[2] 孟锦[1] 栾波[1] Hou Peipei;Yu Qian;Jiao Ni;Meng Jin;Luan Bo(Department of Cardiology,Liaoning Provincial People's Hospital/People's Hospital of China Medical University,Liaoning Province,Shenyang 110016,China;不详)

机构地区：[1]辽宁省人民医院/中国医科大学人民医院心内科,沈阳110016 [2]辽宁省人民医院/中国医科大学人民医院心功能科,沈阳110016

出　　处：《疑难病杂志》2020年第11期1091-1096,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：辽宁省科学技术计划项目(2018020281)。

摘　　要：目的分析高血压性心脏病患者血清血小板反应蛋白1(TSP-1)、尿素氮(BUN)水平及其与预后的相关性。方法选取2017年9月—2019年9月辽宁省人民医院/中国医科大学人民医院心内科收治的原发性高血压患者218例作为研究对象,根据是否合并心脏病分为高血压性心脏病组(高心组)113例,高血压组105例,另选取同期在医院体检的健康者100例作为健康对照组。比较3组心功能指标,血清TSP-1、BUN、高敏C反应蛋白(hs-CRP)、N末端B型利钠肽原(NT-proBNP)水平;分析高血压性心脏病患者血清TSP-1、BUN水平与hs-CRP、NT-proBNP及心功能指标相关性;采用Logistic回归模型分析影响高血压性心脏病患者不良预后发生的因素;利用ROC曲线评价血清TSP-1、BUN水平对高血压性心脏病患者不良预后发生的预测价值。结果健康对照组、高血压组、高心组患者血清TSP-1、BUN、hs-CRP、NT-proBNP及LVEDD、LVESD水平依次升高,LVEF、E/A水平依次降低(F=168.800、305.757、402.741、1260.743、101.909、77.043,364.696、737.701,P均=0.000)。预后不良亚组患者血清TSP-1、BUN、hs-CRP、NT-proBNP及LVEDD、LVESD水平明显高于预后良好亚组,LVEF、E/A水平明显低于预后良好亚组(t=15.591、13.719、11.412、4.016、6.700、6.901、10.584、15.463,P均=0.000)。高血压性心脏病患者血清TSP-1、BUN水平均与NT-proBNP、LVEDD呈正相关,与LVEF、E/A水平呈负相关(TSP-1:r/P=0.362/0.002、0.355/0.003、-0.403/0.000、-0.412/0.000;BUN:r/P=0.341/0.000、0.364/0.002、-0.415/0.000、-0.425/0.000)。Logistic回归分析结果表明,高hs-CRP水平、高NT-proBNP水平、高LVEDD、高TSP-1水平、高BUN水平是影响不良预后发生的危险因素[OR(95%CI)=2.819(1.400~5.675)、2.647(1.254~5.586)、3.106(1.586~6.084)、3.044(1.651~5.611)、3.185(1.766~5.745)],而高LVEF、E/A值是影响不良预后发生的保护因素[0.651(0.482~0.879)、0.596(0.447~0.795)]。血清TSP-1、BUN水平联合预测高血压性心脏病Objective To investigate the expression levels of serum thrombospondin 1(TSP-1)and blood urea nitrogen(BUN)in patients with hypertensive heart disease and their prognostic correlation.Methods Two hundred and eighteen patients with primary hypertension admitted to the Department of Cardiology,People’s Hospital of Liaoning Provincial People’s Hospital/People’s Hospital of China Medical University from September 2017 to September 2019 were selected as the research objects,and they were divided into hypertensive heart disease groups according to whether they had complicated heart disease(There were 113 cases in the high heart group,105 cases in the hypertension group,and 100 healthy people who had a physical examination in the hospital during the same period were selected as the healthy control group.Compare the three groups of cardiac function indicators,serum TSP-1,BUN,serum high-sensitivity C-reactive protein(hs-CRP),N-terminal B-type natriuretic peptide(NT-proBNP)levels,and analyze serum TSP-1,BUN levels in patients with hypertensive heart disease Correlation with hs-CRP,NT-proBNP and cardiac function indicators;Logistic regression model was used to analyze the factors affecting the adverse prognosis of patients with hypertensive heart disease;ROC curve was used to evaluate serum TSP-1,BUN levels on the adverse prognosis of patients with hypertensive heart disease The predicted value of occurrence.Results Serum TSP-1,BUN,hs-CRP,NT-proBNP,LVEDD,and LVESD levels in the healthy control group,hypertension group,and high heart group patients increased sequentially,and the LVEF and E/A values decreased sequentially(F=168.800,305.757,402.741,1260.743,101.909,77.043,364.696,737.701,all P=0.000).The serum TSP-1,BUN,hs-CRP,NT-proBNP,LVEDD,and LVESD levels in the subgroup with poor prognosis were significantly higher than those in the subgroup with good prognosis,and the levels of LVEF and E/A were significantly lower than those in the subgroup with good prognosis(t=15.591,13.719,11.412,4.016,6.700,6.901,10.584,15.463

关 键 词：血小板反应蛋白1 尿素氮 高血压性心脏病 预后 相关性 

分 类 号：R54[医药卫生—心血管疾病]