EGFR联合STAT3与老年阻塞性睡眠呼吸暂停综合征合并高血压患者发生心室重构的关系  

Correlation between Epidermal Growth Factor Receptor Combined with Signal Transducer and Activator of Transcription 3 and Ventricular Remodeling in Elderly Patients with Obstructive Sleep Apnea Syndrome and Hypertension

作　　者：张军营 孙春喜[2] 齐艳莉 ZHANG Junying;SUN Chunxi;QI Yanli(Department of Respiratory Medicine,Shangluo Central Hospital,Shangluo 726000,China;Department of Cardiovascular Medicine,Shangluo Central Hospital,Shangluo 726000,China)

机构地区：[1]陕西省商洛市中心医院呼吸内科,726000 [2]陕西省商洛市中心医院心血管内科,726000

出　　处：《实用心脑肺血管病杂志》2024年第10期36-40,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：陕西省自然科学基础研究计划项目(2021JQ-419)。

摘　　要：目的探讨表皮生长因子受体(EGFR)联合信号转导及转录激活蛋白3(STAT3)与老年阻塞性睡眠呼吸暂停综合征(OSAS)合并高血压患者发生心室重构的关系。方法回顾性选取2020年8月—2023年8月商洛市中心医院收治的87例老年OSAS合并高血压患者,收集患者的临床资料,采用酶联免疫吸附试验测定血清EGFR、STAT3水平,采用超声心动图检测左心室射血分数(LVEF)、相对室壁厚度(RWT)、左心室质量指数(LVMI)。根据心室重构发生情况将患者分为心室重构组(36例)和无心室重构组(51例)。采用多因素Logistic回归分析探讨老年OSAS合并高血压患者发生心室重构的影响因素,采用Pearson相关分析探讨EGFR、STAT3与老年OSAS合并高血压患者LVEF、RWT、LVMI的相关性,采用ROC曲线分析EGFR、STAT3及二者联合对老年OSAS合并高血压患者发生心室重构的预测价值。结果心室重构组OSAS严重程度重于无心室重构组,最低血氧饱和度、LVEF低于无心室重构组,心肌肌钙蛋白I、EGFR、STAT3、RWT、LVMI高于无心室重构组(P<0.05)。多因素Logistic回归分析结果显示,OSAS严重程度〔OR=2.217,95%CI(1.181~4.159)〕、EGFR〔OR=5.371,95%CI(2.335~12.354)〕、STAT3〔OR=3.823,95%CI(1.869~7.818)〕、LVEF〔OR=0.243,95%CI(0.096~0.614)〕、RWT〔OR=5.121,95%CI(1.702~15.470)〕、LVMI〔OR=2.485,95%CI(1.498~4.120)〕是老年OSAS合并高血压患者发生心室重构的独立影响因素(P<0.05)。Pearson相关分析结果显示,EGFR、STAT3与老年OSAS合并高血压患者LVEF呈负相关,与RWT、LVMI呈正相关(P<0.05)。ROC曲线分析结果显示,EGFR、STAT3及二者联合预测老年OSAS合并高血压患者发生心室重构的AUC分别为0.785〔95%CI(0.687~0.884)〕、0.803〔95%CI(0.703~0.904)〕、0.943〔95%CI(0.898~0.989)〕。结论EGFR、STAT3是老年OSAS合并高血压患者发生心室重构的独立影响因素,且二者联合对老年OSAS合并高血压患者发生心室重构预测价值较高。Objective To investigate the correlation between epidermal growth factor receptor(EGFR)combined with signal transducer and activator of transcription 3(STAT3)and ventricular remodeling in elderly patients with obstructive sleep apnea syndrome(OSAS)and hypertension.Methods A total of 87 elderly patients with OSAS and hypertension admitted to Shangluo Central Hospital from August 2020 to August 2023 were retrospectively selected.The clinical data of the patients were collected,serum EGFR and STAT3 levels were measured by enzyme-linked immunosorbent assay.Left ventricular ejection fraction(LVEF),relative wall thickness(RWT)and left ventricular mass index(LVMI)were detected by echocardiography.The patients were divided into ventricular remodeling group(n=36)and non-ventricular remodeling group(n=51)according to the occurrence of ventricular remodeling.Multivariate Logistic regression analysis was used to explore the influencing factors of ventricular remodeling in elderly patients with OSAS and hypertension.Pearson correlation analysis was used to explore the correlation between EGFR,STAT3 and LVEF,RWT,LVMI in elderly patients with OSAS and hypertension.ROC curve was used to explore the predictive value of EGFR,STAT3 and their combination for ventricular remodeling in elderly patients with OSAS and hypertension.Results The severity of OSAS in ventricular remodeling group was greater than that in non-ventricular remodeling group,the lowest oxygen saturation and LVEF were lower than those in non-ventricular remodeling group,and the cardiac troponin I,EGFR,STAT3,RWT and LVMI were higher than those in non-ventricular remodeling group(P<0.05).Multivariate Logistic regression analysis showed that OSAS severity[OR=2.217,95%CI(1.181-4.159)],EGFR[OR=5.371,95%CI(2.335-12.354)],STAT3[OR=3.823,95%CI(1.869-7.818)],LVEF[OR=0.243,95%CI(0.096-0.614)],RWT[OR=5.121,95%CI(1.702-15.470)],LVMI[OR=2.485,95%CI(1.498-4.120)]were independent influencing factors of ventricular remodeling in elderly patients with OSAS and hypertension(P<0.05).

关 键 词：睡眠呼吸暂停 阻塞性 高血压 表皮生长因子受体 转录激活因子3 心室重构 影响因素分析 

分 类 号：R563.8[医药卫生—呼吸系统] R544.1[医药卫生—内科学]