冠心病患者血清CT-1、ANGPTL3、sTNFR1与心功能分级和预后的关系分析  

Relationship among serum CT-1,ANGPTL3,sTNFR1,heart function classification and prognosis in patients with coronary heart disease

作　　者：宋昕 王佳 付群 李长新 Song Xin;Wang Jia;Fu Qun;Li Changxin(Department of Integrative Medicine,Beijing Emergency General Hospital,Beijing 100028,China)

机构地区：[1]北京应急总医院综合医疗科,北京100028 [2]应急总医院心血管内科,北京100028

出　　处：《中国循证心血管医学杂志》2023年第4期477-480,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：应急总医院医学发展科研项目(K201910)。

摘　　要：目的 探讨冠状动脉粥样硬化性心脏病(冠心病)患者血清心肌营养素-1(CT-1)、血管生成素样蛋白3(ANGPTL3)、可溶性肿瘤坏死因子受体1(sTNFR1)与心功能分级及预后的关系。方法 选择2021年1月至2022年6月于北京应急总医院收治的90例冠心病患者作为观察组,另选择同期我院体检的健康人群80例作为对照组,比较两组患者的血清CT-1、ANGPTL3、sTNFR1水平,比较观察组不同心功能分级患者血清CT-1、ANGPTL3、sTNFR1水平,根据患者术后6个月是否发生主要不良心血管事件分为预后不良组16例和预后良好组74例,比较不同预后患者血清CT-1、ANGPTL3、sTNFR1水平,分析血清CT-1、ANGPTL3、sTNFR1和心功能的相关性及对预后的影响因素。结果 观察组血清CT-1、ANGPTL3、sTNFR1均明显高于对照组,差异有统计学意义(P<0.05);观察组心功能Ⅲ级患者血清CT-1、ANGPTL3、sTNFR1均高于Ⅱ级和Ⅰ级患者,且Ⅱ级各指标均高于Ⅰ级,预后不良组患者血清CT-1、ANGPTL3、sTNFR1均高于预后良好组(P<0.05);Pearson相关性分析显示,血清CT-1、ANGPTL3、sTNFR1与心功能分级呈正相关(P<0.05);多因素Logistic回归分析显示,血清CT-1、ANGPTL3、sTNFR1均是影响冠心病患者预后的独立危险因素(P<0.05)。结论 冠心病患者血清CT-1、ANGPTL3、sTNFR1明显升高,不仅与心功能分级具有明显相关性,同时也是影响患者预后的独立危险因素,应予以关注。Objective To investigate the relationship among cardiotrophin-1(CT-1),angiopoietin-like protein 3(ANGPTL3)soluble tumor necrosis factor receptor 1(sTNFRI),heart function classification and prognosis in patients with coronary heart disease(CHD).Methods CHD patients(n=90)were chosen into observation group and meanwhile healthy controls(n=80)were chosen into control group from Beijing Emergency General Hospital from Jan.2021 to June 2022.The levels of serum CT-1,ANGPTL3 and sTNFR1 were compared between 2 groups,and compared among patients with different grades of heart function classification in observation group.The patients were divided,according to whether they suffered from major adverse cardiovascular events(MACE)6 months after treatment or not,into poor prognosis group(n=16)and good prognosis group(n=74).The levels of serum CT-1,ANGPTL3 and sTNFR1 were compared between poor prognosis group and good prognosis group.The correlation among CT-1,ANGPTL3,sTNFR1 and heart function,and influence factors for prognosis were analyzed.Results The levels of serum CT-1,ANGPTL3 and sTNFR1 were higher in observation group than those in control group(P<0.05).In observation group,the levels of serum CT-1,ANGPTL3 and sTNFR1 were higher in patients with grade II of heart function classification than those in patients with grades II and I,and were higher in patients with grade II than those in patients with grade I.The levels of serum CT-1,ANGPTL3 and sTNFRI were higher in poor prognosis group than those in good prognosis group(P<0.05).The results of Pearson correlation analysis showed that levels of serum CT-1,ANGPTL3 and sTNFR1 were positively correlated to heart function classification(P<0.05).The results of multi-factor Logistic regression analysis showed that levels of serum CT-1,ANGPTL3 and sTNFR1 all were independent risk factors for prognosis in CHD patients(P<0.05).Conclusions The levels of serum CT-1,ANGPTL3 and sTNFR1 increase significantly,which are not only significantly correlated to heart function classification,but

关 键 词：冠心病 心肌营养素-1 血管生成素样蛋白3 可溶性肿瘤坏死因子受体1 心功能 预后 

分 类 号：R541.4[医药卫生—心血管疾病]