血清ET-1、Gal-3表达与心力衰竭患者心脏再同步化治疗反应性的相关性分析  

The Correlation between Serum ET-1 and Gal-3 Expression and CRT Treatment Response in Patients with Heart Failure

作　　者：赵德全 赵双凤 黄丽君 ZHAO Dequan;ZHAO Shuangfeng;HUANG Lijun(Department of Cardiovascular Medicine,The Third People’s Hospital of Zhengzhou)

机构地区：[1]郑州市第三人民医院心血管内科,河南郑州450000

出　　处：《长治医学院学报》2025年第1期34-38,共5页Journal of Changzhi Medical College

摘　　要：目的:分析血清内皮素-1(ET-1)、半乳糖凝集素-3(Gal-3)与心力衰竭患者心脏再同步化治疗(CRT)反应性的相关性。方法:回顾性研究确诊并接受CRT的116例慢性心力衰竭患者资料,根据患者CRT反应性情况分为无反应组(n=34)与有反应组(n=82)。比较2组血清ET-1、Gal-3表达及其他资料,通过Logistic回归分析、限制性立方样条法分析血清ET-1、Gal-3表达与心力衰竭患者CRT反应性的相关性,并通过交互作用分析血清ET-1、Gal-3表达对心力衰竭患者CRT反应性的交互作用。结果:无反应组患者入院当天N末端B型脑钠肽前体(NT-proBNP)、ET-1、Gal-3水平均高于有反应组,差异有统计学意义(P<0.05);经Logistic回归分析显示,CRT治疗前NT-proBNP、ET-1、Gal-3高表达是心力衰竭患者CRT无反应性的危险因素(P<0.05);经限制性立方样条法分析显示,血清ET-1、Gal-3、NT-proBNP与心力衰竭患者CRT无反应呈非线性剂量反应关系(P<0.05),当血清ET-1≥101.835 ng·L^(-1),Gal-3≥30.015 ng·mL^(-1),NT-proBNP≥701.285 pg·mL^(-1)时,CRT无反应风险随三者表达的增加而升高;经交互作用分析显示,在控制NT-proBNP这一变量后,血清ET-1、Gal-3表达对心力衰竭患者CRT无反应存在正向交互作用,二者同时过表达时CRT无反应风险是二者同时低表达时的4606.812倍,协同效应为二者单独存在产生效应之和的84.376倍(SI=84.376)。结论:心力衰竭患者入院时血清ET-1、Gal-3表达与CRT反应性有关,呈非线性剂量反应关系,且二者对患者CRT反应性呈交互作用,入院时血清ET-1、Gal-3呈异常过表达可能提示CRT无反应风险。Objective:To analyze the correlation between serum endothelin-1(ET-1),galactin-3(Gal-3),and the response to cardiac resynchronization therapy(CRT)in patients with heart failure.Methods:A retrospective study was conducted to collect data from 116 patients with chronic heart failure who received CRT treatment.According to the patient's responses to CRT treatment,they were divided into a nonresponsive group(n=34)and a responsive group(n=82).The expression of serum ET-1,Gal-3,and other data were compared between the two groups.Logistic regression analysis and restricted cubic spline method were used to analyze the correlation between serum ET-1,Gal-3 expression,and CRT response in patients with heart failure,and the interaction between serum ET-1,Gal-3 expression,and CRT response in patients with heart failure was analyzed by interaction.Results:The levels of N-terminal B-type brain natriuretic peptide precursor(NT-proBNP),ET-1,and Gal-3 in the nonresponsive group were higher than those in the responsive group on the day of admission,and the differences were statistically significant(P<0.05).According to Logistic regression analysis,the results showed that high expression of NT-proBNP,ET-1,and Gal-3 before CRT treatment was a risk factor for nonresponsiveness to CRT treatment in heart failure patients(P<0.05).According to the analysis of the restricted cubic spline method,the results showed a non-linear dose-response relationship between serum ET-1,Gal-3,NT-proBNP,and CRT treatment nonresponse in heart failure patients(P<0.05).When serum ET-1≥101.835 ng·L^(-1),Gal-3≥30.015 ng·L^(-1),and NT-proBNP≥701.285 ng·L^(-1),the risk of CRT treatment nonresponse increased with the increase of their expression.Through interaction analysis,the results showed that after controlling for NT-proBNP as a variable,there was a positive interaction between serum ET-1 and Gal-3 expression and CRT treatment nonresponse in heart failure patients.When both were overexpressed,the risk of CRT treatment nonresponse was 4606.812 times h

关 键 词：心力衰竭 心脏同步化 内皮素-1 半乳糖凝集素-3 剂量反应 

分 类 号：R541[医药卫生—心血管疾病]