血清可溶性重组蛋白信号4D、可溶性CD40配体对原发性高血压患者左心室肥厚的诊断价值  

Diagnostic value of serum soluble semaphorin 4D and soluble CD40 ligand for left ventricular hypertrophy in patients with primary hypertension

作　　者：于向志 刘靖美 苟旭静 张晓歌 寻增艳 王文娟 王均志 武越[3] Yu Xiangzhi;Liu Jingmei;Gou Xujing;Zhang Xiaoge;Xun Zengyan;Wang Wenjuan;Wang Junzhi;Wu Yue(Department of Cardiovascular Medicine,Qingdao Hospital(Qingdao Chengyang District People′s Hospital),Shandong First Medical University,Qingdao 266109,China;Department of Intervention,Qingdao Hospital(Qingdao Chengyang District People′s Hospital),Shandong First Medical University,Qingdao 266109,China;Department of Cardiology,Qingdao City Hospital,Qingdao266011,China)

机构地区：[1]山东第一医科大学附属青岛医院(青岛市城阳区人民医院)心血管内科,青岛266109 [2]山东第一医科大学附属青岛医院(青岛市城阳区人民医院)介入科,青岛266109 [3]青岛市市立医院心内科,青岛266011

出　　处：《中国医师进修杂志》2025年第3期237-242,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨血清可溶性重组蛋白信号4D(sSema4D)、可溶性CD40配体(sCD40L)对原发性高血压(EH)患者左心室肥厚(LVH)的诊断价值。方法前瞻性选取山东第一医科大学附属青岛医院2022年12月至2023年12月收治的84例EH合并LVH患者作为研究组,另外选取同期山东第一医科大学附属青岛医院84例EH未合并LVH患者84例作为对照组。酶联免疫吸附法检测sSema4D、sCD40L水平;Pearson相关性分析血清sSema4D、sCD40L与超声心动测量值的相关性;多因素Logistic回归分析LVH的影响因素;绘制受试者工作特征(ROC)曲线分析血清sSema4D、sCD40L对EH合并LVH的诊断价值。结果研究组血清sSema4D、sCD40L水平显著高于对照组[(8.56±2.19)μg/L比(5.12±1.43)μg/L、(4.02±1.03)μg/L比(3.22±0.98)μg/L],差异均有统计学意义(P<0.05),研究组高血压病程、LVEDD、IVSTD、LVPWT、LVMI显著高于对照组[(7.33±1.53)年比(4.26±1.35)年、(50.28±3.33)mm比(44.45±3.76)mm、(11.64±3.21)mm比(9.53±2.89)mm、(12.45±1.52)mm比(9.13±0.98)mm、(126.11±15.28)g/m^(2)比(81.15±11.31)g/m^(2)],差异均有统计学意义(P<0.05);根据Pearson相关性分析得知,血清sSema4D和sCD40L均与LVEDD、IVSTD、LVPWT、LVMI呈正相关(r=0.425和0.533、0.612和0.436、0.513和0.628、0.589和0.618,P<0.05);多因素Logistic回归分析得知,高血压病程、LVEDD、IVSTD、LVPWT、LVMI、sSema4D、sCD40L是影响EH患者发生LVH的危险因素(P<0.05);根据ROC曲线得知,血清sSema4D诊断EH合并LVH的曲线下面积(AUC)为0.848,血清sCD40L诊断EH合并LVH的AUC为0.725,二者联合诊断EH合并LVH的AUC为0.888,sSema4D和sCD40L联合优于各自单独诊断(Z=2.651和2.526,P<0.05)。结论EH合并LVH患者血清sSema4D、sCD40L水平显著升高,均是EH合并LVH发生的影响因素,二者联合检测对于EH合并LVH具有较高的诊断价值。Objective To explore the diagnostic value of serum soluble semaphorin 4D(sSema4D)and soluble CD40 ligand(sCD40L)in left ventricular hypertrophy(LVH)in patients with primary hypertension(EH).Methods Eighty-four patients with EH combined with LVH admitted to Qingdao Hospital of Shandong First Medical University from December 2022 to December 2023 were prospectively selected as the study group,and 84 patients with EH and without LVH admitted to Qingdao Hospital of Shandong First Medical University during the same period were regarded as the control group.Enzyme linked immunosorbent assay was applied to detect the levels of sSema4D and sCD40L.Employing Pearson correlation coefficient,the study assessed the association between concentrations of sSema4D and sCD40L in serum and various echocardiographic measurements.A multivariate Logistic regression model was engaged to probe into the contributing factors for the development of LVH.ROC curve was plotted to analyze the diagnostic value of serum sSema4D and sCD40L for EH combined with LVH.Results Serum sSema4D and sCD40L levels were significantly higher in the study group than in the control group:(8.56±2.19)μg/L vs.(5.12±1.43)μg/L,(4.02±1.03)μg/L vs.(3.22±0.98)μg/L,and the differences were statistically significant(P<0.05).The duration of hypertension,LVEDD,IVSTD,LVPWT,and LVMI were significantly higher in the study group than in the control group:(7.33±1.53)years vs.(4.26±1.35)years,(50.28±3.33)mm vs.(44.45±3.76)mm,(11.64±3.21)mm vs.(9.53±2.89)mm,(12.45±1.52)mm vs.(9.13±0.98)mm,(126.11±15.28)g/m^(2) vs.(81.15±11.31)g/m^(2),and the differences were statistically significant(P<0.05).According to Pearson correlation analysis,it was known that both serum sSema4D and sCD40L were positively correlated with LVEDD,IVSTD,LVPWT and LVMI(r=0.425 and 0.533,0.612 and 0.436,0.513 and 0.628,0.589 and 0.618;P<0.05).Multivariate Logistic regression analysis showed that hypertension duration,LVEDD,IVSTD,LVPWT,LVMI,sSema4D,sCD40L were risk factors for LVH in EH patients

关 键 词：原发性高血压 左心室肥厚 可溶性重组蛋白信号4D 可溶性CD40配体 诊断 

分 类 号：R54[医药卫生—心血管疾病]