老年慢性心力衰竭病人血清热休克蛋白90水平及其与心功能和预后的关系  

The relationship between serum heat shock protein 90 level and cardiac function and prognosis in elderly patients with chronic heart failure

作　　者：原涛 任丽玮 王学智[1] 高凡 高淑贤 许振坤[1] YUAN Tao;REN Liwei;WANG Xuezhi;GAO Fan;GAO Shuxian;XU Zhenkun(The Second Department of Cardiology,The First Hospital of Handan,Handan,Hebei 056000,China)

机构地区：[1]邯郸市第一医院心内二科,河北邯郸056000

出　　处：《安徽医药》2025年第3期546-550,共5页Anhui Medical and Pharmaceutical Journal

基　　金：邯郸市科学技术研究与发展计划项目(21422083061)。

摘　　要：目的研究老年慢性心力衰竭病人血清热休克蛋白90(Hsp90)表达水平及其与病人心功能和预后的关系。方法收集2020年1月至2021年12月在邯郸市第一医院接受治疗的108例老年慢性心力衰竭病人为研究组,以同时间100例体检者为对照组。将研究组根据美国纽约心脏病学会(NYHA)的标准,分为Ⅱ级组31例、Ⅲ级组42例和Ⅳ级组35例。另外依据病人出院后半年随访结果,分为预后良好组(65例)和预后不良组(43例)。通过酶联免疫吸附测定(ELISA)检测血清Hsp90表达水平;使用超声诊断仪测定左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)以及左心室射血分数(LVEF);分析Hsp90表达水平与心功能指标的关系,及其对慢性心力衰竭预后的预测价值。结果研究组血清Hsp90[(1.45±0.35)μg/L比(0.36±0.10)μg/L]、LVESD和LVEDD较对照组显著升高,LVEF较对照组显著降低(P<0.05)。随着心功能分级的增加,血清Hsp90、LVESD和LVEDD增加,LVEF降低,且各组间比较差异有统计学意义(P<0.05)。慢性心力衰竭病人血清Hsp90表达水平与LVESD和LVEDD呈正相关(r=0.58、0.56,P<0.05),与LVEF呈负相关(r=-0.60,P<0.05)。预后不良组血清Hsp90、LVESD和LVEDD较预后良好组升高,LVEF较预后良好组降低(P<0.05)。血清Hsp90评估慢性心力衰竭病人预后的最佳截断值为1.46μg/L,曲线下面积(AUC)为0.80,灵敏度为83.70%,特异度为76.90%。结论血清中Hsp90表达水平在老年慢性心力衰竭病人中显著升高,与病人心功能和预后密切相关,血清Hsp90水平越高,心功能损伤越严重,病人的预后越差,且Hsp90水平对老年慢性心力衰竭病人的预后具有一定的预测价值。Objective To study the expression level of serum heat shock protein 90(Hsp90)in elderly patients with chronic heart failure,and its relationship with cardiac function and prognosis.Methods A total of 108 elderly patients with chronic heart failure who were treated in The First Hospital of Handan from January 2020 to December 2021 were enrolled as the research group,and 100 healthy subjects having a physical examination at the same time were enrolled as the control group.According to the New York Heart Association(NYHA)criteria,the study group was assigned into grade Ⅱ group(n=31),grade Ⅲ group(n=42),and grade Ⅳ group(n=35).In addition,according to the results of follow-up half a year after discharge,the patients were assigned into good prognosis group(n=65)and poor prognosis group(n=43).The expression level of serum Hsp90 was detected by enzyme-linked immunosorbent assay(ELISA);left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)and the left ventricular ejection fraction(LVEF)were measured by ultrasonic diagnostic equipment.The correlation between the expression level of Hsp90 and cardiac function indexes,and its predictive value for the prognosis of chronic heart failure were analyzed.Results Serum Hsp90[(1.45±0.35)μg/L vs.(0.36±0.10)μg/L],LVESD and LVEDD in the study group were significantly higher than those in the control group,while LVEF was significantly lower than that in the control group(P<0.05).With the increase in cardiac function grade,Serum Hsp90,LVESD and LVEDD increased,while LVEF decreased,and the difference between the groups was statistically significant(P<0.05).The expression level of Hsp90 in serum of patients with chronic heart failure was positively correlated with LVESD and LVEDD(r=0.58,0.56,P<0.05),and negatively correlated with LVEF(r=-0.60,P<0.05).The serum Hsp90,LVESD and LVEDD in the poor prognosis group were higher than those in the good prognosis group,and LVEF was lower than that in the good prognosis group(P<0.05).The optimal cut-of

关 键 词：心力衰竭 热休克蛋白90 心功能 预后 老年人 

分 类 号：R541.6[医药卫生—心血管疾病]