慢性心力衰竭患者血清Sestrin2、骨膜素浓度及其与心功能、预后的关系  

Serum Concentrations of Sestrin2 and Periostin in Patients with Chronic Heart Failure and Their Relationships with Cardiac Function and Prognosis

作　　者：赵欣 王彦辉 王丽 ZHAO Xin;WANG Yanhui;WANG Li(Department of Physical Examination Center,Beijing First Integrated Traditional Chinese and Western Medicine Hospital,Beijing 100026,China;Department of Cardiology,Beijing First Integrated Traditional Chinese and Western Medicine Hospital,Beijing 100026,China;Department of Ultrasound Diagnosis,Beijing First Integrated Traditional Chinese and Western Medicine Hospital,Beijing 100026,China)

机构地区：[1]北京市第一中西医结合医院体检中心,北京100026 [2]北京市第一中西医结合医院心内科,北京100026 [3]北京市第一中西医结合医院超声诊断科,北京100026

出　　处：《岭南心血管病杂志》2025年第1期50-57,共8页South China Journal of Cardiovascular Diseases

基　　金：北京市朝阳区科技计划课题项目(项目编号:CYSF151801)。

摘　　要：目的分析慢性心力衰竭患者血清Sestrin2、骨膜素(periostin,POSTN)浓度及其与心功能、预后的关系。方法选取2022年1月至2022年12月北京市第一中西医结合医院收治的240例慢性心力衰竭患者为研究对象,并根据纽约心脏协会(New York Heart Association,NYHA)心功能分级标准将其分为Ⅱ级组(n=76)、Ⅲ级组(n=95)和Ⅳ级组(n=69)。分析患者的一般临床资料,采用酶联免疫吸附试验(ELISA)检测血清Sestrin2、POSTN浓度,采用Pearson法分析Sestrin2、POSTN与心功能指标的相关性,采用多因素Logistic回归分析对患者预后不良的影响因素进行分析,绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清Sestrin2、POSTN浓度对患者预后的预测价值。结果与Ⅱ级组患者相比,Ⅲ级组和Ⅳ级组患者血清Sestrin2、POSTN浓度及左心房内径(left atrium diameter,LAD)、左心室舒张末期内径(left ventricular end-diastolic internal diameter,LVEDD)显著升高[(9.35±0.96)μg/L、(113.55±13.64)pg/mL、(48.79±5.01)mm、(61.32±6.54)mm,(10.57±1.33)μg/L、(126.35±14.36)pg/mL、(51.32±5.26)mm、(67.85±6.93)mm vs.(7.86±0.82)μg/L、(96.32±9.89)pg/mL、(44.68±4.73)mm、(56.39±5.88)mm],左心射血分数(left ventricular ejection fraction,LVEF)显著降低(49.32%±5.13%、45.36%±4.72%vs.53.21%±5.68%),差异均有统计学意义(P<0.05);且Ⅲ级组患者血清Sestrin2、POSTN浓度、LAD和LVEDD较Ⅳ级组显著升高,LVEF较Ⅳ级组显著降低,差异有统计学意义(P<0.05)。血清Sestrin2、POSTN浓度与LVEF呈负相关(P<0.05),与LAD、LVEDD呈正相关(P<0.05)。预后不良组患者血清Sestrin2、POSTN浓度[(10.17±1.16)μg/L、(121.29±13.81)pg/mL]显著高于预后良好组[(8.65±0.94)μg/L、(105.96±11.95)pg/mL],差异有统计学意义(P<0.05)。且预后不良组患者患原发性高血压(高血压)、冠状动脉粥样硬化性心脏病(冠心病)的比例及LVEF、LAD、LVEDD[60.44%、64.84%、44.40%±4.62%、(52.07±5.29)mm�Objectives To explore and analyze the serum concentrations of Sestrin2 and periostin(POSTN)and their relationship with cardiac function and prognosis in patients with chronic heart failure.Methods From January 2022 to December 2022,240 patients with chronic heart failure admitted to Beijing First Integrated Traditional Chinese and Western Medicine Hospital were regarded as the study subjects,and were separated into gradeⅡgroup(n=76),gradeⅢgroup(n=95),and gradeⅣgroup(n=69)according to the New York Heart Association(NYHA)Function Classifi⁃cation Standard.General clinical data were collected and analyzed.Enzyme-linked immunosorbent assay(ELISA)was applied to detect serum concenrations of Sestrin2 and POSTN.Pearson correlation analysis was applied to analyze the correlation between Sestrin2,POSTN and cardiac function indicators.Multivariate Logistic regression was applied to analyze the influencing factors of poor prognosis.Receiver operating characteristic curve(ROC)was plotted to analyze the predictive value of serum concentrations of Sestrin2 and POSTN for prognosis.Results The serum concentrations of Sestrin2,POSTN,left atrial diameter(LAD),left ventricular end-diastolic internal diameter(LVEDD)[(9.35±0.96)μg/L,(113.55±13.64)pg/mL,(48.79±5.01)mm,(61.32±6.54)mm]and[(10.57±1.33)μg/L,(126.35±14.36)pg/mL,(51.32±5.26)mm,(67.85±6.93)mm]in gradeⅢandⅣgroups significantly increased when compared with those in gradeⅡgroup[(7.86±0.82)μg/L,(96.32±9.89)pg/mL,(44.68±4.73)mm,(56.39±5.88)mm],while left ventricular ejection fraction(LVEF)significantly decreased(49.32%±5.13%,45.36%±4.72%vs.53.21%±5.68%)(P<0.05);and serum concentrations of Sestrin2,POSTN,LAD and LVEDD in gradeⅢgroup significantly increased compared with those in gradeⅣgroup,while LVEF significantly decreased(P<0.05).The serum concentrations of Sestrin2 and POSTN were negatively correlated with LVEF(P<0.05),and positively correlated with LAD and LVEDD(P<0.05).Serum concentra⁃tions of Sestrin2 and POSTN in poor prognosis group[(1

关 键 词：心力衰竭 Sestrin2 骨膜素 心功能 预后 

分 类 号：R541.6[医药卫生—心血管疾病]