老年慢性心力衰竭患者左心室重构与脂联素、胎盘生长因子、内脏脂肪组织来源的丝氨酸蛋白酶抑制剂的关系^*

Relationship between left ventricular remodeling and adiponectin, placental growth factor and visceral adipose tissue-serine protease inhibitors in elderly patients with chronic heart failure

摘要

目的 分析老年慢性心力衰竭(CHF)患者左心室重构(LVR)与脂联素(APN)、胎盘生长因子(PLGF)、内脏脂肪组织来源的丝氨酸蛋白酶抑制剂(Vaspin)的关系。方法 研究为回顾性分析,选取2022—2024年西安医学院第二附属医院收治的60例CHF合并LVR的老年患者为LVR组,另收集同期本院收治的60例未合并LVR的老年CHF患者为单纯CHF组。比较两组LVR相关指标[左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)、左室后壁厚度(LVPWT)、室间隔厚度(IVST)]、血清APN、PLGF、Vaspin水平;分析血清APN、PLGF、Vaspin与老年CHF患者LVR的关系。结果 LVR组LVEF低于单纯CHF组(P＜0.05),LVEDD、LVPWT、IVST均高于单纯CHF组(P＜0.05)。LVR组APN、Vaspin水平低于单纯CHF组(P＜0.05),血清PLGF水平高于单纯CHF组(P＜0.05)。经Pearson相关系数分析,血清PLGF与LVEF呈负相关(P＜0.05),与LVEDD、LVPWT、IVST呈正相关(P＜0.05);血清APN、Vaspin与LVEF呈正相关(P＜0.05),与LVEDD、LVPWT、IVST呈负相关(P＜0.05)。多因素logistic回归分析结果显示:血清PLGF过表达是老年CHF患者合并LVR的独立危险因素(P＜0.05),APN、Vaspin是其保护因素(P＜0.05)。ROC曲线结果显示:血清APN、PLGF、Vaspin单独及联合检测评估老年CHF患者LVR的曲线下面积均＞0.71,有一定评估价值,且联合检测可提高ROC曲线下面积。结论 老年CHF患者LVR与血清APN、PLGF、Vaspin水平有关,且APN、PLGF、Vaspin联合检测可提高老年CHF患者LVR的评估价值。

Abstract

Objective To analyze the relationship between left ventricular remodeling (LVR) and adiponectin (APN), placental growth factor (PLGF), and visceral adipose tissue-serine protease inhibitor(Vaspin) in elderly patients with chronic heart failure (CHF). Methods This study was a retrospective analysis, a total of 60 elderly patients with CHF combined with LVR admitted to the Second Affiliated Hospital of Xi'an Medical College from 2022 to 2024 were collected as the LVR group. Additionally, another 60 elderly patients without LVR admitted to our hospital during the same period were collected as the simple CHF group.LVR related parameters [left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular posterior wall thickness (LVPWT), interventricular septum thickness (IVST)], serum APN, PLGF, and vaspin levels were compared between the two groups; the relationship between serum APN, PLGF, and vaspin and LVR in elderly CHF patients was analyzed. Results The LVEF value in the LVR group was lower than that in the simple CHF group(P<0.05), and the LVEDD, LVPWT, and IVST values were higher than those in the simple CHF group(P<0.05). The levels of Vaspin and APN in the LVR group were lower than those in the simple CHF group(P<0.05), and the serum PLGF was higher than that in the simple CHF group(P<0.05). According to the Pearson correlation test, serum PLGF was negatively correlated with LVEF and positively correlated with LVEDD, LVPWT, and IVST(P<0.05). Serum APN and Vaspin were positively correlated with LVEF and negatively correlated with LVEDD, LVPWT, and IVST (P<0.05). Results of multivariate logistic regression analysis showed that serum PLGF overexpression was a risk factor for LVR in elderly CHF patients, while APN and Vaspin were protective factors (P<0.05). Results of ROC curves analysis showed that the area under the curve of serum APN, PLGF, and Vaspin alone and in combination for evaluating LVR in elderly CHF patients were all greater than 0.71, which had certain evaluation value, and the area under the curve value could be increased by combined detection. Conclusion LVR is associated with serum APN, PLGF and vaspin levels in elderly patients with CHF, and the combined detection of APN,PLGF and vaspin can improve the evaluation value of LVR in elderly patients with CHF.

关键词

慢性心力衰竭 / 左心室重构 / 脂联素 / 胎盘生长因子 / 内脏脂肪组织来源的丝氨酸蛋白酶抑制剂

Key words

Chronic heart failure / Left ventricular remodeling / Adiponectin / Placental growth factor / Visceral adipose tissue-serine protease inhibitor