慢性心力衰竭患者血清HMGB1水平变化及其与病情和预后的关系  

Changes in levels of serum HMBG1 in chronic heart failure and its relationship with the condition and prognosis

作　　者：张丹 成威 高彦琳 戎李 ZHANG Dan;CHENG Wei;GAO Yanin;RONG Li(Graduate School,Bengbu Medical University,Bengbu 233030,China)

机构地区：[1]蚌埠医科大学研究生院,安徽蚌埠233030 [2]安徽省第二人民医院心内科,安徽合肥230022

出　　处：《山东医药》2025年第1期6-9,14,共5页Shandong Medical Journal

基　　金：安徽省高校自然科学研究项目(2023AH053377)。

摘　　要：目的观察慢性心力衰竭(CHF)患者血清高迁移率族蛋白B1(HMGB1)水平变化,探讨其与患者病情严重程度及预后的关系。方法选取CHF患者200例作为CHF组,同期健康体检者20例为对照组。采用ELISA法检测血清HMGB1水平;根据美国纽约心脏病学会(NYHA)的心功能分级方法,将CHF患者按病情严重程度分级;随访24个月,记录患者出院后发生恶性心律失常、心源性死亡和全因死亡等重大不良心血管事件(MACE)的情况。采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析血清HMGB1对CHF患者预后不良的预测价值;Kaplan-Meier生存曲线分析血清HMGB1高表达和低表达患者的预后差异。结果CHF组血清HMGB1水平高于对照组(P<0.05)。200例CHF患者中NYHA心功能分级Ⅱ级41例、Ⅲ级99例、Ⅳ级60例;CHF患者血清N末端B型利钠肽前体(NT-proBNP)、HMGB1水平均随NYHA心功能分级的提升而升高(P均<0.05)。随访24个月,200例CHF患者中发生MACE 65例、未发生MACE 135例;发生MACE的CHF患者血清NT-ProBNP、HMGB1水平均高于未发生MACE的患者(P均<0.05)。ROC曲线分析结果显示,血清HMGB1、血清NT-ProBNP预测CHF患者发生MACE的AUC分别为0.752、0.772,两者联合预测CHF患者发生MACE的AUC为0.863。Kaplan-Merier生存曲线分析结果显示,血清HMGB1高、低水平的CHF患者预后不良发生率分别为67.50%、35.50%,HMGB1高水平者预后不良发生率高于HMGB1低水平者(P<0.05)。结论CHF患者血清HMGB1水平升高,且与患者的病情严重程度有关,其与血清NT-ProBNP联合检测有助于提高预测患者预后的准确性。Objective To observe the changes of serum high-mobility group protein B1(HMGB1)levels in patients with chronic heart failure(CHF),and to explore the relationship between the levels and the severity and prognosis of patients.Methods We selected 200 patients with CHF as the CHF group and 20 healthy subjects as the control group.Serum HMGB1 levels were detected by ELISA.According to the cardiac function grading method of New York Heart Association(NYHA),CHF patients were classified according to the severity of the disease.The patients were followed up for 24 months,and the occurrence of major adverse cardiovascular events(MACE)such as malignant arrhythmia,cardiogenic death,and all-cause death were recorded after discharge.Receiver operating characteristics(ROC)curve and the area under the curve were used to analyze the predictive value of serum HMGB1 for poor prognosis in CHF patients.Kaplan-Meier survival curve was used to analyze the difference in prognosis between patients with high and low serum HMGB1 expression.Results The serum HMGB1 level in the CHF group was higher than that in the control group(P<0.05).Among 200 patients with CHF,41 cases were classified as gradeⅡ,99 cases as gradeⅢ,and 60 cases as gradeⅣ.Serum N-terminal B-type natriuretic peptide precursor(NT-proBNP)and HMGB1 levels in CHF patients increased with the increase of NYHA cardiac function grading(all P<0.05).After 24 months of follow-up,65 of 200 CHF patients developed MACE and 135 did not develop MACE.The levels of serum NT-ProBNP and HMGB1 in CHF patients with MACE were higher than those in patients without MACE(both P<0.05).ROC curve analysis results showed that the AUC of serum HMGB1 and serum NT-ProBNP in predicting the occurrence of MACE in CHF patients was 0.752 and 0.772,respectively,and the AUC of serum HMGB1 combined with serum NT-probNP in predicting the occurrence of MACE in CHF patients was 0.863.Kaplan-Merier survival curve analysis showed that the incidences of poor prognosis in CHF patients with high and low serum HMGB1 l

关 键 词：慢性心力衰竭 高迁移率族蛋白B1 N末端B型利钠肽前体 重大不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]