热休克蛋白27和N末端脑利钠肽前体水平与慢性肺源性心脏病分级及预后的关系  

Correlation of heat shock protein 27 and brain natriuretic peptide levels with chronic pulmonary heart disease patients

作　　者：蓝运竞[1] 陈兴玲[2] 葛利珍 向立权[1] Yun-jing Lan;Xing-ling Chen;Li-zhen Ge;Li-quan Xiang(Department of Cardiology,Fuling Central Hospital,Chongqing 408099,China;Department of Nephrology,Fuling Central Hospital,Chongqing 408099,China;Department of Cardiology,No.6905 Staff Hospital of Chinese People's Liberation Army,Chongqing 400712,China)

机构地区：[1]重庆市涪陵中心医院心内科,重庆408099 [2]重庆市涪陵中心医院肾内科,重庆408099 [3]中国人民解放军第6905厂职工医院心内科,重庆400712

出　　处：《中国现代医学杂志》2021年第17期85-90,共6页China Journal of Modern Medicine

摘　　要：目的探讨热休克蛋白27(HSP27)和N末端脑利钠肽前体(NT-proBNP)水平与慢性肺源性心脏病(以下简称慢性肺心病)的关系。方法选取重庆市涪陵中心医院120例慢性肺心病患者(观察组)和100例年龄、性别相匹配正常人群(对照组)为研究对象。比较两组血清HSP27、NT-proBNP水平差异;比较不同心功能分级观察组患者血清HSP27、NT-proBNP水平;采用Logistic回归分析慢性肺心病患者死亡的影响因素;绘制受试者工作特征(ROC)曲线,分析HSP27、NT-proBNP和HSP27+NT-proBNP联合检测对慢性肺心病患者的预后价值。结果观察组血清HSP27、NT-proBNP水平高于对照组(P<0.05);血清HSP27、NT-proBNP水平随NYHA心功能分级的升高而升高(P<0.05)。本组所有慢性肺心病患者均获得随访,死亡12例。死亡患者血清HSP27、NT-proBNP水平高于存活患者(P<0.05)。多因素Logistic回归分析显示,NYHA分级Ⅲ、Ⅳ级[OR=1.521(95%CI:1.302,6.352)]、HSP27[OR=2.353(95%CI:1.564,10.549)]和NT-proBNP[OR=2.754(95%CI:1.513,12.356)]是慢性肺心病患者死亡的影响因素。血清HSP27、NT-proBNP和HSP27+NT-proBNP联合检测3种方式对慢性肺心病患者预后的AUC为0.723(95%CI:0.538,0.908)、0.859(95%CI:0.807,0.911)、0.876(95%CI:0.742,1.000),敏感性为70.37%、71.55%和77.78%,特异性为89.23%、89.23%和91.01%。结论慢性肺心病患者血清HSP27、NT-proBNP水平升高,且与患者心功能分级和预后有关。Objective To investigate the correlation of heat shock protein 27(HSP27)and brain natriuretic peptide precursor(NT-proBNP)levels with chronic pulmonary heart disease(CPHD).Methods One hundred and twenty patients with CPHD disease(observation group)and 100 age-and sex-matched normal people were selected as the control group.The difference of serum HSP27 and NT-proBNP levels between the two groups observed,and the relationships of the levels of HSP27 and NT-proBNP with the cardiac function classification and prognosis of CPHD patients were analyzed.Results The levels of serum HSP27 and NT-proBNP in the observation group were higher than those in the control group(P<0.05).The levels of serum HSP27 and NT-proBNP increased with the increase of NYHA cardiac function grade(P<0.05).Follow-up was performed on all patients with CPHD in this group,and 12 died.The serum levels of HSP27 and NT-proBNP in the death group were higher than those in the survival group(P<0.05).Multivariate logistic regression analysis showed that NYHA grade Ⅲ and Ⅳ[OR=1.521(95%CI:1.302,6.352)],HSP27[OR=2.353(95%CI:1.564,10.549)],and NT-proBNP[OR=2.754(95%CI:1.513,12.356)]were the influencing factors of death in patients with CPHD.The AUC was 0.723(95%CI:0.538,0.908),0.859(95%CI:0.807,0.911),and 0.876(95%CI:0.742,1.000),and the sensitivity and specificity were 70.37%,71.55%,77.78%,89.23%,89.23%,91.01%,respectively.Conclusion The levels of HSP27 and NT proBNP were significantly increased in CPHD patients,and were closely related to the cardiac function and prognosis.

关 键 词：慢性肺源性心脏病 热休克蛋白27 脑利钠肽前体 心功能 预后 

分 类 号：R541.5[医药卫生—心血管疾病]