原发性高血压患者血清标志物与心肌肥厚的相关性分析  

Correlation between serum markers and myocardial hypertrophy in patients with essential hypertension

作　　者：刘一炫[1] 蒙荣森[1] 廖禄明 李萍[2] Liu Yixuan;Meng Rongsen;Liao Luming;Li Ping(Third Department of Cardiology,the Second People's Hospital of Guangdong Province,Guangzhou 510300,Guangdong Province,China)

机构地区：[1]广东省第二人民医院心内三科,广州510300 [2]广东省第二人民医院内分泌科,广州510300

出　　处：《中华老年心脑血管病杂志》2023年第4期368-372,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：广州市科学技术局项目(202108050520130004)。

摘　　要：目的探讨原发性高血压患者血清热休克蛋白47(HSP47)、β_(1)肾上腺素能受体自身抗体(β_(1)ARAb)、可溶性生长刺激表达基因2蛋白(sST2)与心肌肥厚的相关性。方法前瞻性选取2019年1月至2021年1月广东省第二人民医院收治的原发性高血压患者(B组)以及原发性高血压伴心肌肥厚患者(C组)各105例,同时纳入105例健康体检人群作为A组。分析原发性高血压患者血清HSP47、β_(1)ARAb、sST2水平与心肌肥厚的相关性。结果与A组比较,B组与C组尿素、LDL-C、收缩压、舒张压、左心室后壁舒张末期厚度(LVPWTD)、HSP47、β_(1)ARAb水平显著增高,HDL-C、左心房直径(LAD)、sST2水平显著降低(P<0.05);与B组比较,C组尿素、空腹血糖、HSP47、β_(1)ARAb水平显著增高,HDL-C、左心室舒张末期内径(LVEDD)、LVPWTD、室间隔舒张末期厚度(IVSTD)、LVEF、LAD、sST2水平显著降低,差异有统计学意义(P<0.05)。Spearman相关性分析显示,血清sST2水平与原发性高血压伴心肌肥厚呈负相关(r=-0.842,P=0.000),血清HSP47、β_(1)ARAb水平与原发性高血压伴心肌肥厚呈正相关(r=0.421,P=0.000;r=0.752,P=0.000)。血清HSP47、β_(1)ARAb、sST2水平与LVEDD、LVPWTD、IVSTD、LVEF呈负相关(P<0.01),与LAD呈正相关(P<0.01)。多因素logistic回归分析显示,血清HSP47、β_(1)ARAb、sST2水平与原发性高血压伴心肌肥厚有相关性(P<0.05,P<0.01)。ROC曲线分析显示,血清HSP47、β_(1)ARAb、sST2水平的曲线下面积分别为0.836(95%CI:0.760~0.913)、0.892(95%CI:0.831~0.954)、0.735(95%CI:0.641~0.829),有统计学差异(P<0.05)。结论原发性高血压患者血清HSP47、β_(1)ARAb、sST2水平与心肌肥厚存在相关性,该血清指标可作为临床上辅助诊断、评估原发性高血压伴心肌肥厚的指标之一。Objective To investigate the correlation of the serum levels of heat shock protein 47(HSP47),β_(1)adrenergic receptor autoantibody(β_(1)ARAb)and soluble growth stimulating gene 2 protein(sST2)with myocardial hypertrophy in patients with essential hypertension.Methods A total of 105patients with essential hypertension(group B)and 105patients with essential hypertension combined with myocardial hypertrophy(group C)admitted in our hospital from January 2019to January 2021were recruited prospectively,and another 105healthy individuals who taking physical examination during the same period were included as group A.The correlation of serum HSP47,β_(1)ARAb and sST2levels with myocardial hypertrophy was analyzed in the patients with essential hypertension.Results Compared with the patients of group A,those of the group B and group C had significantly higher urea and LDL-C levels,increased systolic and diastolic blood pressure and LVPWTD,and elevated HSP47andβ_(1)ARAb levels,but lower HDL-C and sST2levels and LAD(P<0.05).Obviously higher urea,fasting glucose,HSP47andβ_(1)ARAb levels,and reduced HDL-C and sST2levels and LVEDD,LVPWTD,IVSTD,LVEF and LAD were observed in group C than group B(P<0.05).Spearman's correlation analysis showed that serum sST2level was negatively correlated with(r=-0.842,P=0.000),and serum HSP47andβ_(1)ARAb levels were positively correlated with primary hypertension with myocardial hypertrophy(r=0.421,P=0.000;r=0.752,P=0.000).While,the serum HSP47,β_(1)ARAb,and sST2levels were negatively correlated with LVEDD,LVPWTD,IVSTD and LVEF(P<0.01)and positively with LAD(P<0.01).Multivariate logistic regression analysis indicated that serum HSP47,β_(1)ARAb and sST2levels were associated with essential hypertension complicated with myocardial hypertrophy(P<0.05,P<0.01).ROC curve analysis displayed that the area under the curve for serum HSP47,β_(1)ARAb,and sST2levels were 0.836(95%CI:0.760-0.913),0.892(95%CI:0.831-0.954),and 0.735(95%CI:0.641-0.829),respectively,with significant differences(P<0.05).Co

关 键 词：高血压 热休克蛋白质类 受体 肾上腺素能β1 心肌病 肥厚性 可溶性生长刺激表达基因2蛋白 

分 类 号：R544.11[医药卫生—心血管疾病]