血清sTWEAK、sLOX-1与H型高血压合并HFpEF患者颈动脉粥样硬化的关系  

Study on the correlations between serum sTWEAK,sLOX-1,and carotid atherosclerosis in patients with H-type hypertension complicated by HFpEF

作　　者：姜金钟[1] 郭华[1] 苗维[2] 田守森 田雯艳[2] IANG Jin-zhong;GUO Hua;MIAO Wei;TIAN Shou-sen;TIAN Wen-yan(Department of Internal Medicine-Cardiovascular,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei,Cangzhou 061012,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院心内科,河北沧州061012 [2]河北省沧州中西医结合医院神经科,河北沧州061012

出　　处：《广东医学》2024年第10期1226-1230,共5页Guangdong Medical Journal

基　　金：河北省医学科学研究重点课题计划项目(20160394)。

摘　　要：目的研究血清可溶性肿瘤坏死因子样凋亡弱诱导因子(sTWEAK)、可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)与H型高血压合并射血分数保留的心力衰竭(HFpEF)患者颈动脉粥样硬化的关系。方法选取2021年2月至2023年3月沧州中西医结合医院收治的161例H型高血压合并HFpEF患者,按是否发生颈动脉粥样硬化分为硬化组与非硬化组。同期选取80例于我院体检的健康的志愿者作为对照组。收集受试者的临床资料,采用酶联免疫吸附法检测血清sTWEAK、sLOX-1水平,比较H型高血压合并HFpEF患者与对照组血清sTWEAK、sLOX-1水平,采用多因素logistic回归分析患者发生颈动脉粥样硬化的影响因素,受试者工作特征(ROC)曲线分析血清sTWEAK、sLOX-1对患者发生颈动脉粥样硬化的预测价值。结果161例患者中65例发生颈动脉粥样硬化,发生率为40.37%(65/161),未发生颈动脉粥样硬化者96例。两组在年龄、吸烟、血脂四项等方面比较,差异有统计学意义(P<0.05)。硬化组与非硬化组血清sTWEAK水平低于对照组,sLOX-1水平高于对照组(P<0.05);且硬化组sTWEAK水平低于非硬化组,sLOX-1水平高于非硬化组(P<0.05)。多因素logistic回归分析显示,HDL-C、sTWEAK、年龄、LDL-C、sLOX-1水平是患者发生颈动脉粥样硬化的影响因素(P<0.05)。ROC曲线显示,血清sTWEAK、sLOX-1联合检测对发生颈动脉粥样硬化的预测曲线下面积(AUC)为0.842,预测效能高于两指标单独检测。结论H型高血压合并HFpEF患者的血清sTWEAK水平下降、sLOX-1水平上升,与颈动脉粥样硬化发生有关,两者联合检测对颈动脉粥样硬化的发生具有一定预测价值。Objective To investigate the relationship between serum soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK),soluble lectin-like oxidized low-density lipoprotein receptor-1(sLOX-1),and carotid atherosclerosis in patients with H-type hypertension complicated by heart failure with preserved ejection fraction(HFpEF).Methods A total of 161 patients with H-type hypertension and HFpEF admitted to Cangzhou Traditional Chinese and Western Medicine Hospital from February 2021 to March 2023 were selected.They were divided into atherosclerosis and non-atherosclerosis groups based on the presence of carotid atherosclerosis.Additionally,80 healthy volunteers undergoing routine health checks were selected as a control group.Clinical data were collected,and serum levels of sTWEAK and sLOX-1 were measured using enzyme-linked immunosorbent assay(ELISA).The serum levels of sTWEAK and sLOX-1 in patients with H-type hypertension and HFpEF were compared to those in the control group.Multivariate logistic regression analysis was conducted to identify factors influencing carotid atherosclerosis,and receiver operating characteristic(ROC)curve analysis was performed to assess the predictive value of serum sTWEAK and sLOX-1 for carotid atherosclerosis.Results Among the 161 patients,65 were found to have carotid atherosclerosis,resulting in an incidence rate of 40.37%(65/161).Significant differences were observed between the two groups regarding age,smoking,and lipid levels(P<0.05).Serum sTWEAK levels were lower in both atherosclerosis and non-atherosclerosis groups compared to the control group,while sLOX-1 levels were higher(P<0.05).Additionally,sTWEAK levels were lower and sLOX-1 levels were higher in the atherosclerosis group compared to the non-atherosclerosis group(P<0.05).Multivariate logistic regression analysis indicated that HDL-C,sTWEAK,age,LDL-C,and sLOX-1 levels were significant factors influencing the occurrence of carotid atherosclerosis(P<0.05).The ROC curve analysis revealed that the combined detection of s

关 键 词：H型高血压 射血分数保留心力衰竭 颈动脉粥样硬化 可溶性肿瘤坏死因子样凋亡弱诱导因子 可溶性凝集素样氧化型低密度脂蛋白受体-1 

分 类 号：R541.6[医药卫生—心血管疾病] R544.1[医药卫生—内科学]