血清HDAC2、SFRP2水平与老年慢性心力衰竭患者心室重构的关系  

Relationship between serum HDAC2, SFRP2 levels and ventricular remodeling in elderly patients with chronic heart failure

作　　者：卢子望 李飞 陈万林[1] 张春莹 Lu Ziwang;Li Fei;Chen Wanlin;Zhang Chunying(Department of Cardiovascular Internal Medicine,Baoji People's Hospital,Shaanxi Province,Baoji 721000,China)

机构地区：[1]陕西省宝鸡市人民医院心血管内一科,721000

出　　处：《疑难病杂志》2023年第3期231-235,240,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金资助项目(81770345)。

摘　　要：目的 探讨老年慢性心力衰竭(CHF)患者血清组蛋白脱乙酰酶2(HDAC2)、分泌型卷曲相关蛋白2(SFRP2)表达水平与心室重构的相关性。方法 选择2021年1月—2022年6月宝鸡市人民医院心血管内一科诊治老年CHF患者117例为CHF组,根据心功能分级分为Ⅱ级47例、Ⅲ级38例、Ⅳ级32例;选择同期在医院体检健康者120例为健康对照组。采用ELISA法检测血清HDAC2、SFRP2水平,超声心动图检查心功能相关指标[左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室质量指数(LVMI)、左心室射血分数(LVEF)、左心室重构指数(LVRI)],Pearson分析CHF患者血清HDAC2、SFRP2与心室重构指标的相关性,受试者工作特征曲线(ROC)分析血清HDAC2、SFRP2对CHF的诊断价值。结果 CHF组血清HDAC2、N末端脑钠肽前体(NT-proBNP)水平显著高于健康对照组,SFRP2水平显著低于健康对照组[t(Z)/P=14.476/<0.001、17.465/<0.001、23.903/<0.001];血清HDAC2水平比较Ⅱ级<Ⅲ级<Ⅳ级(F/P=54.632/<0.001),血清SFRP2水平比较Ⅱ级>Ⅲ级>Ⅳ级(F/P=78.503/<0.001)。CHF组LAD、LVEDD、LVMI显著高于健康对照组,LVEF、LVRI显著低于健康对照组(t/P=15.221/<0.001、14.824/<0.001、9.728/<0.001、20.848/<0.001、8.335/<0.001);LAD、LVEDD、LVMI水平比较,Ⅱ级<Ⅲ级<Ⅳ级(F/P=71.571/<0.001、45.980/<0.001、16.697/<0.001),LVEF、LVRI比较,Ⅱ级>Ⅲ级>Ⅳ级(F/P=101.017/<0.001、16.544/<0.001)。Pearson分析显示,血清HDAC2与LAD、LVEDD、LVMI、NT-proBNP呈正相关(P<0.01),与LVEF、LVRI呈负相关(P<0.01);血清SFRP2与LAD、LVEDD、LVMI、NT-proBNP呈负相关(P<0.01),与LVEF、LVRI呈正相关(P<0.01)。ROC曲线结果显示,血清HDAC2、SFRP2及二者联合预测CHF的曲线下面积(AUC)分别为0.827、0.865、0.931,二者联合预测效能高于单独检测(Z/P=3.258/0.001,2.286/0.022)。结论 CHF患者血清HDAC2水平升高,SFRP2水平降低,与心室重构相关,可作为临床辅助评估CHF患者病情的指标。Objective To investigate the relationship between the expression of serum histone deacetylase 2(HDAC2), secretory curl associated protein 2(SFRP2) and ventricular remodeling in elderly patients with chronic heart failure(CHF). Methods One hundred and seventeen elderly patients with CHF diagnosed and treated by the First Department of Cardiology of Baoji People’s Hospital from January 2021 to June 2022 were selected as the CHF group. According to the classification of cardiac function, they were divided into 47 cases of grade II, 38 cases of grade III, and 32 cases of grade IV;120 healthy people were selected as the healthy control group. The levels of serum HDAC2 and SFRP2 were detected by ELISA, and the indexes related to cardiac function(left atrial diameter(LAD), left ventricular end-diastolic diameter(LVEDD), left ventricular mass index(LVMI), left ventricular ejection fraction(LVEF), and left ventricular remodeling index(LVRI)) were examined by echocardiography The diagnostic value of SFRP2 for CHF. Results The serum levels of HDAC2 and N-terminal pro-brain natriuretic peptide(NT-proBNP) in CHF group were significantly higher than those in healthy control group, and the level of SFRP2 was significantly lower than that in healthy control group(t(Z)/P=14.476/<0.001, 17.465/<0.001, 23.903/<0.001);The serum HDAC2 level was compared with Grade II < Grade III < Grade IV(F/P=54.632/< 0.001), and the serum SFRP2 level was compared with Grade II > Grade III > Grade IV(F/P=78.503/< 0.001). LAD, LVEDD and LVMI in CHF group were significantly higher than those in healthy control group, and LVEF and LVRI were significantly lower than those in healthy control group(t/P=15.221/<0.001, 14.824/<0.001, 9.728/<0.001, 20.848/<0.001, 8.335/<0.001);Compared with LAD, LVEDD and LVMI, Level II < Level III < Level IV(F/P=71.571/< 0.001, 45.980/< 0.001, 16.697/< 0.001), LVEF and LVRI, Level II > Level III > Level IV(F/P=101.017/< 0.001, 16.544/< 0.001). Pearson analysis showed that serum HDAC2 was positively correlated with LAD, LV

关 键 词：慢性心力衰竭 组蛋白脱乙酰酶2 分泌型卷曲相关蛋白2 心室重构 老年人 

分 类 号：R541.6[医药卫生—心血管疾病]