老年冠心病合并慢性肾脏病患者血清可溶性生长刺激表达基因2蛋白与心脏舒张功能的关系  

Relationship between serum sST2 and cardiac diastolic function in elderly patients with coronary heart disease and chronic kidney disease

作　　者：李慧颖 朱兵[1] 蔡力力[2] 刘燊 刘宏斌[1] 朱启伟[1] Li Huiying;Zhu Bing;Cai Lili;Liu Shen;Liu Hongbin;Zhu Qiwei(Department of Cardiovascular Diseases,Second Medical Center&National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心心血管内科、国家老年疾病临床医学研究中心,北京100853 [2]解放军总医院第二医学中心检验科、国家老年疾病临床医学研究中心,北京100853 [3]北京卫戍区石景山离职干部休养所

出　　处：《中华老年心脑血管病杂志》2025年第3期270-273,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家老年疾病临床医学研究中心开放课题(NCRCG-PLAGH-2022018);军队保健专项重点项目(22BJZ26)。

摘　　要：目的探讨老年冠心病合并慢性肾脏病患者血清可溶性生长刺激表达基因2蛋白(soluble suppression of tumorigenicity 2 protein,sST2)与心脏舒张功能的关系。方法选取2021年4月至2022年7月于解放军总医院第二医学中心健康体检的老年冠心病合并慢性肾脏病患者116例,根据sST2水平分为高sST2组(sST2>28.65μg/L)58例和低sST2组(sST2≤28.65μg/L)58例。收集所有患者基线资料,包括N末端B型钠尿肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、舒张早期二尖瓣血流峰值速度(E)、舒张早期二尖瓣环运动速度(e′)、等容舒张时间(isovolumetric relaxation time,IVRT)等指标。利用化学发光法测血清sST2水平,采用Pearson相关性分析和多元线性回归分析。结果高sST2组糖尿病、β受体阻滞剂、sST2、尿素、logNT-proBNP、左心室质量指数、左心室后壁厚度、E/e′和IVRT明显高于低sST2组,血红蛋白、三酰甘油和平均e′明显低于低sST2组,差异有统计学意义(P<0.05,P<0.01)。相关性分析显示,sST2与β受体阻滞剂、尿素、log NT-proBNP及E/e′呈正相关(r=0.226,P=0.015;r=0.362,P=0.001;r=0.374,P=0.001;r=0.257,P=0.005),与三酰甘油、血红蛋白及e′呈负相关(r=-0.227,P=0.014;r=-0.314,P=0.001;r=-0.203,P=0.029)。多元线性回归分析显示,sST2与三酰甘油、尿素、logNT-proBNP及E/e′呈多元线性相关(P<0.05,P<0.01)。结论老年冠心病和慢性肾脏病患者血清sST2水平与心脏舒张功能相关。Objective To investigate the relationship between serum soluble suppression of tumorigenicity 2(sST2)and cardiac diastolic function in elderly patients with coronary heart disease(CHD)and chronic kidney disease(CKD).Methods A total of 116 elderly CHD patients suffering from CKD taking physical examinations at the Second Medical Center of Chinese PLA General Hospital from April 2021 to July 2022 were recruited,and according to their serum sST2 level,they were divided into high sST2 group(>28.65μg/L,58 cases)and low sST2 group(<28.65μg/L,58 cases).The baseline data of all subjected patients were collected,including N-terminal pro-B-type natriuretic peptide(NT-proBNP),as well as peak early diastolic mitral flow velocity(E),peak early diastolic mitral annular velocity(e'),isovolumetric relaxation time(IVRT)and some other indicators in echocardiography.Serum sST2 level was measured using chemiluminescence assay.Pearson correlation analysis and multiple linear regression analysis were used for analysis.Results The high sST2 group had significantly larger proportion of diabetes and usingβ-blockers,higher levels of sST2,urea and logNT-proBNP,increased left ventricular mass index,thicker left ventricular posterior wall thickness,and elevated E/e'and IVRT,and lower levels of hemoglobin and triacylglycerol,and decreased e'value when compared with the low sST2 group(P<0.05,P<0.01).The correlation analysis showed that sST2 was positively correlated with takingβ-blockers,urea and logNT-proBNP levels,and E/e'ratio(r=0.226,P=0.015;r=0.362,P=0.001;r=0.374,P=0.001;r=0.257,P=0.005),and negatively correlated with triglycerides,hemoglobin and e'value(r=—0.227,P=0.014;r=—0.314,P=0.001;r=—0.203,P=0.029).Multiple linear regression analysis displayed that sST2 was linearly correlated with triglycerides,urea and NT-proBNP levels,and E/e'(P<0.05,P<0.01).Conclusion Serum sST2 level is correlated with cardiac diastolic function in elderly patients with comorbidities of CHD and CKD.

关 键 词：冠心病 心脏 回归分析 临床研究 

分 类 号：R692[医药卫生—泌尿科学] R541.4[医药卫生—外科学]