血清AKR1B10、FGF21联合检测对HHD不良预后的预测价值  

Diagnostic value of combined detection of serum AKR1B10 and FGF21 for poor prognosis of HHD

作　　者：吴定坤[1] 王俊[1] 邢俊武[1] WU Dingkun;WANG Jun;XING Junwu(Department of Cardiology,the Affiliated Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing University of Chinese Medicine,Nanjing 210014,Jiangsu,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院心血管病科,江苏南京210014

出　　处：《中南医学科学杂志》2024年第5期800-803,共4页Medical Science Journal of Central South China

基　　金：南京市卫生科技发展专项资金项目(YKK23190);南京市卫生健康委员会项目(YKK23190)。

摘　　要：目的 探讨血清醛酮还原酶家族1成员B10(AKR1B10)和成纤维细胞生长因子21(FGF21)联合检测对高血压心肌病(HHD)患者不良预后的预测价值。方法 选取本院HHD患者145例为研究对象。根据随访结束时有无主要不良心血管事件(MACE),将患者分为无MACE组84例及MACE组61例。比较两组临床资料及血清AKR1B10、FGF21水平。采用Spearman相关分析AKR1B10、FGF2水平与HHD患者不良预后的相关性。采用多因素Logistic回归分析HHD不良预后的影响因素;采用ROC评估血清AKR1B10、FGF21联合检测对HHD患者发生不良预后的诊断效能。结果 与无MACE组相比,MACE组体质指数(BMI)、高脂血症占比、左心室舒张期末内径、室间隔厚度、左心室心肌质量指数及血清AKR1B10水平升高,β-受体阻滞剂、血管紧张素转换酶抑制剂及血管紧张素受体拮抗剂治疗占比及血清FGF21水平降低(P<0.05)。HHD不良预后与AKR1B10呈正相关(P<0.001),而与FGF21水平呈负相关(P<0.001)。BMI升高、2型糖尿病、AKR1B10的升高及FGF21水平的降低是HHD患者发生不良预后的危险因素。血清AKR1B10联合FGF21检测效能高于单独指标检测,对HHD患者的不良预后具有较高的预测价值。结论 血清AKR1B10联合FGF21检测对HHD患者不良预后具有较高的预测价值。Aim To explore the predictive value of combined detection of serum aldo-keto reductase family 1 member B10(AKR1B10) and fibroblast growth factor 21(FGF21) for poor prognosis in patients with hypertensive heart disease(HHD).Methods 145 patients with HHD in our hospital were selected as the research subjects.At the end of follow-up,based on the presence or absence of major adverse cardiovascular events(MACE),the patients were divided into non-MACE group(84 cases) and MACE group(61 cases).The clinical data and serum levels of AKR1B10 and FGF21 between two groups were compared.The correlation between AKR1B10,and FGF2 levels and poor prognosis in HHD patients was analyzed by Spearman correlation analysis.The factors affecting the adverse prognosis of HHD was analyzed by multivariate Logistic regression.The diagnostic efficacy of serum AKR1B10 and FGF21 combined detection for adverse prognosis in HHD patients was evaluated by ROC.Results Compared with the non-MACE group,the body mass index(BMI),the proportion of hyperlipidemia,left ventricular end diastolic dimension,interventricular septal diameter,left ventricular myocardial mass index and serum AKR1B10 levels were increased in MACE group.The proportion of β-blockers,angiotensin-converting enzyme inhibitors and angiotensin-receptor antagonists and FGF21 levels were decreased(P<0.05).The adverse prognosis of HHD was positively correlated with AKR1B10(P<0.001),but negatively correlated with FGF21(P<0.001).Elevated BMI,type 2 diabetes mellitus,elevated AKR1B10 and decreased FGF21 levels were independent risk factors for poor prognosis in HHD patients.The efficacy of serum AKR1B10 combined with FGF21 is higher than that of single index,and it has high predictive value for poor prognosis of HHD patients.Conclusion Serum AKR1B10 combined with FGF21 has a high predictive value for poor prognosis in patients with HHD.

关 键 词：高血压心肌病 AKR1B10 FGF21 不良预后 

分 类 号：R541.3[医药卫生—心血管疾病]