肌肉生长抑制素8和沉默信息调节因子4与老年慢性心力衰竭心肌重构和心功能损伤的相关性  

Correlation of expression of GDF-8 and Sir4 with myocardial remodeling and cardiac dysfunction in elderly patients with CHF

作　　者：朱慎慎 胡艳敏 王钰莹[1] 黄亚萍[1] 吴照科[1] Zhu Shenshen;Hu Yanmin;Wang Yuying;Huang Yaping;Wu Zhaoke(Department of Geriatrics,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,Henan Province,China)

机构地区：[1]郑州大学第二附属医院老年医学科,450014

出　　处：《中华老年心脑血管病杂志》2024年第11期1287-1291,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河南省医学科技攻关计划项目(LHGJ20190309)。

摘　　要：目的 探讨血清肌肉生长抑制素8(growth differentiation factor-8,GDF-8)和沉默信息调节因子4(silent information regulator 4,Sir4)在老年慢性心力衰竭(chronic heart failure, CHF)中的表达及其与左心室重构和心功能之间的关系。方法 选取2021年1月至2023年12月在郑州大学第二附属医院就诊的CHF患者300例为观察组,纳入同期在郑州大学第二附属医院体检的健康人群100例为对照组;观察组患者根据纽约心脏病协会(New York Heart Association, NYHA)心功能分级分为Ⅰ级组60例、Ⅱ级组72例、Ⅲ级组102例、Ⅳ级组66例。收集临床资料,检测血清GDF-8和Sir4,采用超声心动图检查确定左心室重构情况,采用NYHA心功能分级评估心功能损伤程度。采用Pearson相关性分析和Spearman相关性分析对GDF-8、Sir4与左心室重构、心肌损伤之间的相关性进行分析。结果 观察组左心房内径、左心室舒张末期内径、左心室后壁厚度、室间隔厚度、左心室质量指数、Sir4、GDF-8水平显著高于对照组[(42.46±4.75)mm vs(36.39±5.33)mm,(54.63±7.96)mm vs(47.42±8.08)mm,(9.44±1.21)mm vs(8.49±0.88)mm,(9.27±1.58)mm vs(8.66±1.71)mm,(141.49±5.32)g/m^(2)vs(106.52±7.33)g/m^(2),(3.69±1.06)g/L vs(1.48±0.42)g/L,(33.75±10.64)g/L vs(19.08±5.13)g/L,P<0.01],左心室射血分数、左心室重构指数显著低于对照组[(40.02±10.14)%vs(63.64±6.13)%,(1.05±0.24)g/ml vs(1.32±0.33)g/ml,P<0.01]。Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组Sir4和GDF-8水平及左心室质量指数逐渐升高,左心室重构指数逐渐下降,4组间比较差异有统计学意义(P<0.01)。Pearson相关性分析和Spearman相关性分析显示,Sir4、GDF-8与左心房内径、左心室舒张末期内径、左心室后壁厚度、室间隔厚度、左心室质量指数、NHYA心功能分级呈正相关(P<0.01),与左心室射血分数、左心室重构指数呈负相关(P<0.01)。结论 Sir4、GDF-8在老年CHF患者中异常升高,其表达水平与左心室重�Objective To explore the expression of serum growth differentiation factor-8(GDF-8)and silent information regulator 4(Sir4)in elderly patients with chronic heart failure(CHF)and their relationship with left ventricular remodeling and cardiac function.Methods A total of 300 CHF patients admitted in our hospital from Jan 2021 to Dec 2023 were recruited and assigned into an observation group,and 100 healthy individuals who took physical examination during the same period served as control group.Based on New York Heart Association(NYHA)heart function classification,the patients in the observation group were divided into GradeⅠ(60 cases),Ⅱ(72 cases),Ⅲ(102 cases),andⅣ(66 cases)subgroups.Their clinical data were collected,serum GDF-8 and Sir4 levels were detected,left ventricular remodeling was evaluated with echocardiography,and cardiac dysfunction was assessed with NYHA cardiac function grading.Pearson and Spearman correlation analyses were used to analyze the correlation of GDF-8 and Sir4 levels with left ventricular remodeling and myocardial injury.Results The observation group had significantly larger left atrial diameter(LAD)and left ventricular end diastolic diameter(LVEDD),thicker left ventricular posterior wall thickness(LVPWT)and interventricular septum thickness(IVST),and higher left ventricular mass index(LVMI)and serum Sir4 and GDF-8 levels(42.46±4.75 mm vs 36.39±5.33 mm,54.63±7.96 mm vs 47.42±8.08 mm,9.44±1.21 mm vs 8.49±0.88 mm,9.27±1.58 mm vs 8.66±1.71 mm,141.49±5.32 g/m^(2) vs 106.52±7.33 g/m^(2),3.69±1.06 g/L vs 1.48±0.42 g/L,33.75±10.64 g/L vs 19.08±5.13 g/L,P<0.01),but lower LVEF[(40.02±10.14)%vs(63.64±6.13)%,P<0.01]and left ventricular remodeling index(LVRI,1.05±0.24 g/ml vs 1.32±0.33 g/ml,P<0.01)when compared with the control group.The levels of Sir4 and GDF-8,as well as LVMI,were gradually increased,while the LVRI was decreased in GradesⅠ,Ⅱ,Ⅲ,andⅣsubgroups in turn,with statistical differences in the subgroups(P<0.01).Pearson and Spearman correlation analyses showe

关 键 词：心力衰竭 心室重构 肌肉生长抑制素 沉默信息调节因子4 

分 类 号：R541.6[医药卫生—心血管疾病]