血清骨硬化蛋白、OPG、OPG/TRAIL比值对高血压伴慢性心力衰竭患者发生主要不良心血管事件的预测价值  

Predictive value of serum sclerostin,OPG and OPG/TRAIL ratio for major adverse cardiovascular events in hypertensive patients with chronic heart failure

作　　者：阮杨 魏欣[1] 李群[1] RUAN Yang;WEI Xin;LI Qun(Department of Cardiology,Beijing Tiantan Hospital Affiliated to the Capital Medical University,Beijing 100071,China)

机构地区：[1]首都医科大学附属北京天坛医院心内科,北京100071

出　　处：《检验医学与临床》2024年第13期1945-1949,1954,共6页Laboratory Medicine and Clinic

摘　　要：目的探讨血清骨硬化蛋白、骨保护素(OPG)/肿瘤坏死因子相关凋亡诱导配体(TRAIL)比值对高血压伴慢性心力衰竭(CHF)患者发生主要不良心血管事件(MACE)的预测价值。方法选取2019年10月至2022年10月于该院就诊的134例高血压伴CHF患者作为研究对象,根据患者治疗1年内是否发生MACE将其分为MACE组(46例)和无MACE组(88例)。另选取同期于该院进行体检的74例健康者作为对照组。采用酶联免疫吸附实验检测3组血清骨硬化蛋白、OPG和TRAIL水平。收集所有患者的临床资料(包括冠心病史、糖尿病史、收缩压、舒张压)。检测3组血清胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6和IL-10水平。采用Pearson相关分析高血压伴CHF患者血清骨硬化蛋白、OPG和TRAIL水平与相关实验室指标水平的关系。采用多因素Logistic回归分析高血压伴CHF患者发生MACE的危险因素。绘制受试者工作特征(ROC)曲线评估血清骨硬化蛋白、OPG/TRAIL比值单独及2项指标联合检测对MACE的预测价值。结果无MACE组和MACE组血清骨硬化蛋白、OPG水平及OPG/TRAIL比值均明显高于对照组,TRAIL水平明显低于对照组,差异均有统计学意义(P<0.05)。MACE组血清骨硬化蛋白、OPG水平及OPG/TRAIL比值均明显高于无MACE组,TRAIL水平明显低于无MACE组,差异均有统计学意义(P<0.05)。MACE组TNF-α、IL-10、IL-6水平均高于无MACE组,差异均有统计学意义(P<0.05)。MACE组和无MACE组冠心病史和糖尿病史患者比例、收缩压、舒张压以及TC、TG、HDL-C、LDL-C水平比较,差异均无统计学意义(P>0.05)。高血压伴CHF患者血清骨硬化蛋白、OPG水平与TNF-α、IL-10、IL-6水平均呈正相关(P<0.05),TRAIL水平与TNF-α、IL-10、IL-6水平均呈负相关(P<0.05)。多因素Logistic回归分析结果显示,骨硬化蛋白水平升高、OPG水平升高�Objective To investigate the predictive value of serum sclerostin and osteoprotegerin(OPG)/tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)ratio for major adverse cardiovascular events(MACE)in hypertensive patients with chronic heart failure(CHF).Methods A total of 134 patients with hypertension and CHF who were treated in this hospital from October 2019 to October 2022 were selected as the research objects.According to whether MACE occurred within 1 year of treatment,the patients were divided into MACE group(46 cases)and non-MACE group(88 cases).In addition,74 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.The serum levels of sclerostin,OPG and TRAIL in the three groups were detected by enzyme-linked immunosorbent assay.The clinical data(including history of coronary heart disease,diabetes,systolic blood pressure,diastolic blood pressure)of patients were collected.The levels of serum total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),tumor necrosis factor-α(TNF-α),interleukin(IL)-6 and IL-10 were detected in the three groups.Pearson correlation analysis was used to analyze the relationship between serum sclerostin,OPG and TRAIL levels and related laboratory indicators in hypertensive patients with CHF.Multivariate Logistic regression was used to analyze the risk factors of MACE in hypertensive patients with CHF.The receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of serum sclerostin,OPG/TRAIL ratio alone and the combined detection of the two indexes for MACE.Results The levels of serum sclerostin,OPG and OPG/TRAIL ratio in the non-MACE group and the MACE group were significantly higher than those in the control group(P<0.05),and the level of TRAIL was significantly lower than that in the control group(P<0.05).The levels of serum sclerostin,OPG and OPG/TRAIL ratio in MACE group were significantly higher than th

关 键 词：骨硬化蛋白 骨保护素 肿瘤坏死因子相关凋亡诱导配体 高血压伴慢性心力衰竭 主要不良心血管事件 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]