不稳定型心绞痛患者外周血TGF-β1、ET-1对室性心律失常的预测价值及近期预后影响  

Predictive value to ventricular arrhythmias and influence on short-term prognosis of transforming growth factorβ1 and endothelin-1 in patients with unstable angina

作　　者：汪玮 刘志红 曾磊 Wang Wei;Liu Zhihong;Zeng Lei(Department of Cardiovascular Medicine,Hospital of Traditional Chinese Medicine of Lu'an City,Anhui Province,Lu`an 237006,China;不详)

机构地区：[1]安徽省六安市中医院心血管内科,六安237006

出　　处：《中国循证心血管医学杂志》2022年第5期624-628,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探究不稳定型心绞痛(UA)患者血清转化生长因子-β1(TGF-β1)、内皮素-1(ET-1)水平对室性心律失常(VA)的预测价值及近期预后的影响。方法纳入2016年9月至2020年9月于安徽省六安市中医院心内科收治的UA患者364例,从入院起随访3个月;根据有无发生室性心律失常分为室性心律失常组(173例)和非室性心律失常组(191例),根据是否发生心源性死亡分为死亡组(21例)和生存组(343例)。比较不同分组患者血清TGF-β1、ET-1水平;采用ROC曲线评估TGF-β1、ET-1对室性心律失常的预测作用;通过多因素Logistic回归分析TGF-β1、ET-1对UA患者3个月预后的影响。结果173例(47.53%)患者发生室性心律失常;室性心律失常组患者血清TGF-β1水平低于非室性心律失常组,血清ET-1水平高于非室性心律失常组,差异有统计学意义(P<0.05)。ROC曲线分析显示:血清TGF-β1、ET-1预测室性心律失常的AUC分别为0.715(95%CI:0.662~0.768)、0.778(95%CI:0.730~0.825);TGF-β1预测敏感度为79.8%、特异度为52.9%,ET-1预测敏感度为61.3%、特异度为80.1%。随访期间死亡21例(5.77%);死亡组患者血清TGF-β1<329.27 pg/ml、血清ET-1>16.67 ng/L、Lown分级>Ⅲ级的占比高于生存组,且死亡组患者年龄、心率高于生存组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示:年龄<70岁(OR=4.566,95%CI:1.173~17.781)、TGF-β1<329.27 pg/ml(OR=5.188,95%CI:1.128~23.862)、ET-1>16.67 ng/L(OR=3.292,95%CI:1.150~9.427)、Lown分级>Ⅲ级(OR=3.296,95%CI:1.236~8.792)是UA患者死亡的独立危险因素(P<0.05)。结论血清TGF-β1、ET-1对UA患者发生室性心律失常具有预测作用,且与年龄、Lown分级共同影响UA患者近期预后。Objective To investigate the predictive value of transforming growth factorβ1(TGF-β1)and endothelin-1(ET-1)to ventricular arrhythmias(VA)and their influence on short-term prognosis in patients with unstable angina(UA).Methods UA patients(n=364)were chosen from Department of Cardiovascular Medicine in Hospital of Traditional Chinese Medicine of Lu`an City of Anhui Province from Sept.2016 to Sept.2020,and followed up for 3 months at hospitalization time.All patients were divided,according to whether or not VA occurred,into VA group(n=173)and non-VA group(n=191),and all patients were divided,according to whether or not cardiac death occurred,into death group(n=21)and survival group(n=343).The levels of serum transforming growth factorβ1(TGF-β1)and endothelin-1(ET-1)were compared among all groups.The predictive value of TGF-β1 and ET-1 to VA was reviewed by using ROC curve.The influence of TGF-β1 and ET-1 on 3-month prognosis in UA patients was analyzed by using multi-factor Logistic regression analysis.Results VA occurred in 173 patients(47.53%).The level of serum TGF-β1 was lower,and level of serum ET-1 was higher in VA group than those in non-VA group(P<0.05).The results of ROC curve analysis showed that AUC of TGF-β1 was 0.715(95%CI:0.662~0.768)and AUC of ET-1 was 0.778(95%CI:0.730~0.825)in VA prediction.The sensitivity of TGF-β1 was 79.8%and specificity was 52.9%,and sensitivity of ET-1 was 61.3%and specificity was 80.1%.There were 21 cases(5.77%)died during follow-up period.The percentages of TGF-β1<329.27 pg/ml,ET-1>16.67 ng/L,Lown grading>gradeⅢwere higher in death group than those in survival group,and age and heart rate were higher in death group than those in survival group(P<0.05).The results of Logistic regression analysis showed that age<70(OR=4.566,95%CI:1.173~17.781),TGF-β1<329.27 pg/ml(OR=5.188,95%CI:1.128~23.862),ET-1>16.67 ng/L(OR=3.292,95%CI:1.150~9.427),Lown grading>gradeⅢ(OR=3.296,95%CI:1.236~8.792)all were independent risk factors of death in UA patients(P<0.05).Conclusion TGF-β

关 键 词：不稳定型心绞痛 转化生长因子-Β1 内皮素-1 室性心律失常 

分 类 号：R541.4[医药卫生—心血管疾病]