慢性心力衰竭患者Arg389Gly基因多态性与改善心室重塑及临床预后的关系  

Relationship between Arg389Gly gene polymorphism and improved ventricular remodelling and clinical prognosis in patients with chronic heart failure

作　　者：杨丹 黄宇理[1] 徐淑楠 YANG Dan;HUANG Yu-li;XU Shu-nan(Department of Cardiovascular Medicine,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院心血管内科,安徽蚌埠233004

出　　处：《中华全科医学》2023年第2期221-224,349,共5页Chinese Journal of General Practice

基　　金：安徽省高校人文社会科学项目(sk2020A0351)。

摘　　要：目的 探讨β1肾上腺素受体Arg389Gly基因多态性与慢性心力衰竭患者心功能变化情况及临床预后的关系。方法 选取2020年4月-2021年5月蚌埠医学院第一附属医院的慢性心力衰竭患者120例,根据Arg389Gly基因型将患者分成CC组(43例)、GC组(56例)、GG组(21例)3组。收集患者入院时的临床资料,出院后通过门诊或电话对其进行6个月的随访,分析3组患者药物治疗前后心功能变化情况及临床预后。结果 Arg389Gly基因型频率分别为35.8%(CC)、46.7%(GC)、17.5%(GG);随访6个月后,3组患者在氨基末端脑钠肽前体(NT-proBNP)降幅、左心室射血分数(LVEF)升幅及左心室舒张末期内径(LVDD)、左心室收缩末期内径(LVDS)降幅上的差异均有统计学意义(均P<0.05),且CC组的改善情况显著优于GG组(P<0.017);3组患者的可溶性生长刺激表达基因2蛋白(sST2)降幅在随访至6个月时其差异有统计学意义(P=0.006),且CC组优于GG组(P=0.014)。在随访过程中出现了心源性死亡、因心力衰竭再入院、恶性心律失常事件的患者共44例,log-rank检验提示3组患者终点事件发生率的差异有统计学意义(P=0.026),Kaplan-Meier曲线提示CC组终点事件的发生率低于GG组。结论 Arg389Gly基因多态性与慢性心力衰竭患者的心功能变化及临床预后有关。Objective To investigate the relationship between β1 adrenergic receptor Arg389Gly gene polymorphism and cardiac function changes and clinical prognosis in patients with chronic heart failure. Methods A total of 120 patients with chronic heart failure who were admitted in the First Affiliated Hospital of Bengbu Medical College from April 2020 to May 2021 were selected. Based on the Arg389Gly genotype, patients were divided into CC(43 cases), GC(56 cases) and GG(21 cases) groups. Clinical data were collected at admission, and patients were followed up for 6 months by outpatient or telephone after discharge and the changes of cardiac function and clinical prognosis of patients in 3 groups before and after drug treatment were analyzed. Results The frequency of the Arg389Gly genotype was in the following order: CC(35.8%), GC(46.7%) and GG(17.5%). After 6 months of follow-up, there were statistically significant differences in N-terminal pro-brain natriuretic peptide(NT-proBNP) decrease, left ventricular ejection fraction(LVEF) increase, left ventricular end diastolic dimension(LVDD) and left ventricular end-systolic diameter(LVDS) decrease among the three groups(all P<0.05), and the improvement of CC group was significantly better than that of GG group(P<0.017). The decrease of soluble growth stimulation expression gene 2 protein(sST2) in the three groups was statistically significant at 6 months follow-up(P=0.006), and the CC group was better than the GG group(P=0.014). During follow-up, a total of 44 patients had cardiac death, readmission caused by heart failure and malignant arrhythmia events. Log-rank test indicated that the incidence of endpoint events in the three groups was statistically significant(P=0.026). Kaplan-Meier curve indicated that the incidence of endpoint events in the CC group was lower than that in the GG group. Conclusion Arg389Gly gene polymorphism is associated with cardiac function changes and clinical prognosis in patients with chronic heart failure.

关 键 词：心力衰竭 Arg389Gly基因 基因多态性 心室重塑 预后 

分 类 号：R541.6[医药卫生—心血管疾病]