缺血性心肌病患者血清YKL-40、IMA、H-FABP浓度与其预后的相关性  

Correlations between serum concentrations of YKL-40,IMA,H-FABP and prognosis in patients with ischemic cardiomyopathy

作　　者：张占帅[1] 秦少强[1] 王亚玲[1] 石金铮[1] 王蕊[1] ZHANG Zhan-shuai;QIN Shao-qiang;WANG Ya-ling;SHI Jin-zheng;WANG Rui(Department of Cardiology,The First Affiliated Hospital of Hebei North University,Shijiazhuang 075000,China)

机构地区：[1]河北北方学院附属第一医院心内科,张家口075000

出　　处：《岭南心血管病杂志》2022年第1期72-76,83,共6页South China Journal of Cardiovascular Diseases

基　　金：张家口市2016年度科技计划自筹经费项目(项目编号:16210910)。

摘　　要：目的探讨血清几丁质酶-3样蛋白-1(chitinase-3-like protein-1,YKL-40)、缺血修饰白蛋白(ischemia modified albumin,IMA)、心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)在缺血性心肌病(ischemic cardiomyopathy,ICM)患者中的价值及其与预后的相关性。方法选取2017年5月至2018年10月在河北北方学院附属第一医院就诊的153例ICM患者作为观察组,另外选取同期在本院进行健康体检者130名作为对照组。检测2组研究对象的心功能指标及N末端脑钠肽前体(N-terminal pro brain natriuretic peptide,NT-proBNP)浓度,采用酶联免疫吸附法(ELISA)检测血清YKL-40、IMA、H-FABP浓度。采用Spearman分析对ICM患者各指标间相关性进行分析;记录ICM患者12个月随访期内生存状况并计算无进展生存时间,进行生存分析;采用COX回归模型分析影响ICM患者预后的危险因素。结果与对照组相比,观察组左心室射血分数(left ventricular ejection fraction,LVEF)较低,左心室舒张末期容积(left ventricular end diastolic volume,LVEDV)、左心室收缩末期容积(left ventricular end systolic volume,LVESV)及血清NT-proBNP、YKL-40、IMA、H-FABP浓度均较高,差异有统计学意义(P<0.05)。Spearman分析结果显示,ICM患者血清YKL-40、IMA、H-FABP浓度分别与LVEF呈负相关,均与LVEDV、LVESV、NT-proBNP呈正相关(均P<0.05),且3者间互为正相关(均P<0.05)。12个月随访期内,153例ICM患者中有51例发生终点事件,终点事件发生率为33.33%。与YKL-40、IMA、H-FABP低浓度患者相比,YKL-40、IMA、H-FABP高浓度患者的终点事件发生率较高(χ2=10.249、4.719、8.170,P<0.05),无进展生存期较短(Log-rank值为9.404、4.188、6.938,P<0.05),差异有统计学意义。COX回归分析显示,血清YKL-40、IMA、H-FABP、NT-proBNP浓度升高均是影响ICM患者预后不良的独立危险因素(P<0.05)。结论ICM患者血清YKL-40浓度明显升高,与心功能、IMA、H-FABP相关,且是影响ICM患者预后不�Objectives To investigate the value of serum concentrations of chitinase-3-like protein-1(YKL-40),ischemia modified albumin(IMA),heart-type fatty acid-binding protein(H-FABP)in patients with ischemic cardio⁃myopathy(ICM)and their correlations with prognosis.Methods A total of 153 cases of ICM patients in The First Affiliated Hospital of Hebei North University from May 2017 to October 2018 were selected as observation group,and 130 cases of healthy people in our hospital during the same period were selected as control group.Cardiac function indexes and N-terminal pro-brain natriuretic peptide(NT-proBNP)concentration were detected.Serum concentrations of YKL-40,IMA,H-FABP were detected by enzyme linked immunosorbent assay(ELISA).Spearman analysis was used to analyze the correlations between the indicators of ICM patients.The survival status of ICM patients was recorded during the 12-month follow-up period and the progression free survival time was calculated.The survival of patients with ICM was analyzed.COX regression model was used to analyze the risk factors affecting the prognosis of patients with ICM.Results Compared with control group,observation group had lower left ventricular ejection fraction(LVEF),higher left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)and serum concentrations of NT-proBNP,YKL-40,IMA and H-FABP(P<0.05).Spearman analysis showed that serum concen⁃trations of YKL-40,IMA and H-FABP in patients with ICM negatively correlated with LVEF,and positively correlated with LVEDV,LVESV and NT-proBNP(all P<0.05),and all of them positively correlated with each other(P<0.05).During the 12-month follow-up period,51 out of 153 patients with ICM had endpoint events,and the incidence of endpoint events was 33.33%.Compared with those with low serum concentrations of YKL-40,IMA and H-FABP,the patients with high serum concentrations of YKL-40,IMA and H-FABP had higher incidences of end-point events(χ2=10.249,4.719,8.170,P<0.05),and shorter progression free survival(Lo

关 键 词：缺血性心肌病 几丁质酶-3样蛋白-1 缺血修饰白蛋白 心型脂肪酸结合蛋白 预后 

分 类 号：R542.2[医药卫生—心血管疾病]