扩张型心肌病慢性心力衰竭患者血清POSTN、STAT3水平变化及其临床意义  

Changes in serum POSTN and STAT3 levels in patients with chronic heart failure in dilated cardiomyopathy and their clinical significance

作　　者：黄磊磊 幸红燕 周果[1] HUANG Leilei;XING Hongyan;ZHOU Guo(Department of Cardiology,Qijiang District People's Hospital,Chongqing 401420,China)

机构地区：[1]重庆市綦江区人民医院心内科,重庆401420

出　　处：《山东医药》2023年第31期28-32,共5页Shandong Medical Journal

基　　金：重庆市科卫联合医学科研项目(2019MSXM070)。

摘　　要：目的探讨扩张型心肌病(DCM)慢性心力衰竭(CHF)患者血清骨膜蛋白(POSTN)、信号转导子和转录激活子3(STAT3)水平与病情严重程度及预后的关系。方法选取142例DCM CHF患者为DCM CHF组、50名健康体检志愿者为对照组。根据纽约心脏病协会(NYHA)心功能分级将DCM CHF患者分为Ⅰ级组16例、Ⅱ级组27例、Ⅲ级组53例、Ⅳ级组46例;对DCM CHF患者随访1年,根据预后情况分为预后不良组53例和预后良好组89例。用酶联免疫吸附法检测血清POSTN、STAT3;用Spearman相关法分析DCM CHF患者血清POSTN、STAT3水平与NYHA心功能分级的相关性;用多因素Logistic回归分析DCM CHF患者预后不良的影响因素;绘制受试者工作特征(ROC)曲线,分析血清POSTN、STAT3水平对DCM CHF患者预后不良的预测价值。结果DCM CHF组血清POSTN、STAT3水平均高于对照组(P均<0.05)。Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组血清POSTN、STAT3水平依次升高(P均<0.05)。DCM CHF患者血清POSTN、STAT3水平与NYHA心功能分级呈正相关(r_(s)分别为0.814、0.808,P均<0.05)。高龄、NYHA心功能分级≥Ⅲ级及血清NT-proBNP、POSTN、STAT3水平升高是DCM CHF患者预后不良的独立危险因素(P均<0.05),LVEF高是独立保护因素(P<0.05)。ROC曲线分析显示,血清POSTN联合STAT3预测DCM CHF患者预后不良的曲线下面积大于二者单独预测(P均<0.05)。结论DCM CHF患者血清POSTN、STAT3水平升高,二者水平变化可反映病情严重程度,血清POSTN联合STAT3对DCM CHF患者预后不良的预测效能高。Objective To investigate the relationships between serum periostin(POSTN),signal transductor and transcriptional activator 3(STAT3)levels and disease severity and prognosis in patients with chronic heart failure(CHF)in dilated cardiomyopathy(DCM).Methods Totally 142 patients with DCM CHF(the DCM CHF group)and 50 healthy physical examination volunteers(the control group)were selected.According to the New York Heart Association(NYHA)cardiac function classification,the patients with DCM CHF were divided into the Class Ⅰ group of 16 cases,Class Ⅱ group of 27 cases,Class Ⅲ group of 53 cases and Class Ⅳ group of 46 cases.The patients with DCM CHF were followed up for 1 year,and were divided into the poor prognosis group(53 cases)and good prognosis group(89 cases)according to the prognosis.Enzyme-linked immunosorbent assay was used to detect serum POSTN and STAT3 in the two groups.Spearman correlation method was used to analyze the correlation between serum POSTN and STAT3 levels and NYHA cardiac function classification in patients with DCM CHF.Multifactorial Logistic regression was used to analyze the influencing factors of poor prognosis in patients with DCM CHF.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum POSTN and STAT3 levels on poor prognosis of DCM CHF patients.Results Serum POSTN and STAT3 levels were higher in the DCM CHF group than in the control group(both P<0.05).Serum POSTN and STAT3 levels increased sequentially in the Class Ⅰ,Class Ⅱ,Class Ⅲ,and Class Ⅳ groups(all P<0.05).Spearman's correlation method analysis showed that serum POSTN and STAT3 levels were positively correlated with NYHA cardiac function class in patients with DCM CHF(r_(s)=0.814 and 0.808,respectively;all P<0.05).Multifactorial Logistic regression analysis showed that the older age,NYHA cardiac function class≥Ⅲ,high N-terminal pro-B-type natriuretic peptide level,high POSTN level,and high STAT3 level were independent risk factors for poor prognosis of DCM CHF patients,an

关 键 词：扩张型心肌病 慢性心力衰竭 骨膜蛋白 信号转导子和转录激活子3 预后 

分 类 号：R542.2[医药卫生—心血管疾病]