慢性心力衰竭患者血清热休克蛋白27和可溶性糖蛋白130水平与近期预后的相关性

摘要

Objective To explore clinical short?term prognostic value of heat shock protein 27 (HSP27)and soluble glycoprotein 130(Sgp130)on chronic heart failure(CHF). Methods From January 2014 to January 2016,116 patients with CHF in Renmin Hospital of Wuhan University were enrolled in this study. They were followed up for 6 months. According to major adverse cardiac events( MACE) outcome,the patients were divided into non?MACE group ( 83 cases ) and MACE group ( 33 cases ) . Logistic regression analysis was used to analyze the risk factors of MACE. Results Compared with non?MACE group, diabetes,dilated cardiomyopathy, NYHA classification, LVEF, LVEDD, LVESD, E/A, HSP27 and Sgp130 showed significant difference( all P<0. 05 ) . Logistic regression analysis showed that risk factors of MACE included NYHA classification(OR:5. 283,95%CI:2. 861?9. 460,P=0. 003),LVEF(OR:1. 647,95%CI:1. 242?1. 845,P=0. 036),LVEDD(OR:5. 281,95%CI:2. 782?10. 018,P=0. 018),LVESD(OR:4. 735, 95%CI:2.240?8.062,P =0.020),E/A(OR:3.546,95% CI:1.844?4.307,P =0.027),HSP27(OR:1. 844,95%CI:1. 153?3. 638, P =0. 015 ) and Sgp130 ( OR:3. 064, 95% CI:1. 519?4. 233, P=0. 008). Spearman correlation analysis showed that HSP27 and Sgp130 had a negative correlation with LVEF as well as E/A(all P<0. 01)and positive correlation with LVEDD,LVESD,NYHA(all P<0. 01). ConclusionsThe dynamic changes of HSP27 and Sgp130 concentration may have a prognostic value for cardiac function on CHF patients.%目的 探讨血清热休克蛋白27(HSP27)和可溶性糖蛋白130(Sgp130)在评估慢性心力衰竭(CHF)患者近期预后方面的临床价值.方法 收集2014年1月至2016年1月武汉大学人民医院重症医学科就诊的116例CHF患者的病历资料,随访6个月,根据是否发生主要不良心血管事件(MACE)分为2组,即非MACE组(n=83)和MACE组(n=33),采用Logistic回归分析MACE发生的相关危险因素.结果与非MACE组比较,MACE组在糖尿病、扩张型心肌病、纽约心脏病协会(NYHA)分级、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)和舒张早期最大血流速度/舒张晚期最大血流速度(E/A)、HSP27和Sgp130等方面差异均有统计学意义(均为P<0.05).多因素Logistic回归分析结果显示,CHF患者发生MACE的危险因素包括NYHA分级(OR:5.283,95%CI:2.861~9.460,P=0.00)、LVEF(OR:1.647,95%CI:1.242~1.845,P=0.04)、LVEDD(OR:5.281,95%CI:2.782~10.018,P=0.02)、LVESD(OR:4.735,95%CI:2.240~8.062,P=0.02)、E/A(OR:3.546,95%CI:1.844~4.307,P=0.03)、HSP27(OR:1.844,95%CI:1.153~3.638,P=0.02)和Sgp130(OR:3.064,95%CI:1.519~4.233,P=0.01).Spearman相关分析结果显示,血清HSP27和Sgp130水平与LVEF和E/A呈显著负相关(均为P<0.01),而与LVEDD、LVESD和NYHA分级呈明显正相关(均为P<0.01).结论 血清Sgp130和HSP27水平的动态变化对CHF患者心功能状态和预后评估具有较好的应用价值.