摘要
目的探讨血清肌肉生长抑制素(MSTN)、肌肉环指蛋白1(MuRF-1)水平与老年慢性心力衰竭(CHF)患者预后的关系。方法选择老年CHF患者195例(观察组),其中NYHA心功能分级Ⅰ级57例、Ⅱ级62例、Ⅲ级48例、Ⅳ级28例,同期随机选择体检健康的老年志愿者73例(对照组),采集清晨空腹肘静脉血,离心留取血清,采用ELISA法检测血清MSTN、MuRF-1。分析老年CHF患者血清MSTN、MuRF-1水平与NYHA心功能分级的关系。采用Logistic回归模型分析老年CHF患者预后不良的危险因素。采用受试者工作特征(ROC)曲线分析血清MSTN、MuRF-1水平对老年CHF患者预后不良的预测价值。结果观察组血清MSTN、MuRF-1水平均高于对照组(P均<0.01)。随着NYHA心功能分级升高,老年CHF患者血清MSTN、MuRF-1水平逐渐升高(P均<0.05)。老年CHF患者血清MSTN、MuRF-1水平与NYHA心功能分级均呈正相关关系(P均<0.01)。多因素Logistic回归分析显示,病程、NYHA心功能分级、LVEF、NT-proBNP、MSTN、MuRF-1均为老年CHF患者预后不良的独立危险因素(P均<0.05)。ROC曲线分析显示,血清MSTN、MuRF-1水平单独和联合预测老年CHF患者预后不良的曲线下面积(AUC)分别为0.788、0.789、0.894,血清MSTN、MuRF-1水平联合预测老年CHF患者预后不良的AUC大于血清MSTN、MuRF-1水平单独(P均<0.01)。结论老年CHF患者血清MSTN、MuRF-1水平升高,其水平变化与心功能恶化密切相关;血清MSTN、MuRF-1是老年CHF患者预后不良的独立危险因素,可作为预测老年CHF患者预后不良的生物学指标。
Objective To investigate the relationships between serum myostatin(MSTN),muscle ring finger protein 1(MuRF-1)and the prognosis of elderly patients with chronic heart failure(CHF).Methods Totally 195 elderly patients with CHF were selected(observation group),including 57 cases of NYHA cardiac function gradeⅠ,62 cases of NYHA cardiac function gradeⅡ,48 cases of NYHA cardiac function gradeⅢ,and 28 cases of NYHA cardiac function gradeⅣ.In the same period,73 healthy elderly volunteers(control group)were randomly selected.Fasting elbow venous blood was collected in the morning,centrifuged and retained,and the serum MSTN and MuRF-1 were detected by ELISA.We analyzed the relationships between serum MSTN,MuRF-1 levels and NYHA cardiac function grade in elderly patients with CHF.Multivariate Logistic regression model was used to analyze the factors influencing poor prognosis of elderly CHF patients.The ROC curve was used to analyze the predictive value of serum MSTN,MuRF-1 levels for poor prognosis in elderly CHF patients.Results Serum MSTN and MuRF-1 levels in the observation group were higher than those in the control group(both P<0.01).With the increase of NYHA cardiac function grade,the levels of serum MSTN and MuRF-1 in elderly patients with CHF increased gradually(both P<0.01).Serum MSTN and MuRF-1 levels in elderly CHF patients were positively correlated with NYHA classification(both P<0.01).Multivariate Logistic regression analysis showed that the course of disease,NYHA cardiac function grade,LVEF,NT-proBNP,MSTN and MuRF-1 were independent risk factors for poor prognosis of elderly patients with CHF(all P<0.05).The area under the curve(AUC)of serum MSTN and MuRF-1 alone and combined in predicting the poor prognosis of elderly patients with CHF was 0.788,0.789,and 0.894 respectively.The AUC of serum MSTN and MuRF-1 combined to predict the poor prognosis of elderly patients with CHF was greater than that of serum MSTN and MuRF-1 alone(both P<0.01).Conclusions Serum MSTN and MuRF-1 in elderly patients with CHF increase,and their changes are closely related to the deterioration of cardiac function.Serum MSTN and MuRF-1 levels are independent risk factors for poor prognosis of elderly patients with CHF,and can be used as biological indicators to predict poor prognosis of elderly patients with CHF.
作者
董荣
王志华
陈龙锦
马旭
DONG Rong;WANG Zhihua;CHEN Longjin;MA Xu(Department of Cardiology,Yancheng First People′s Hospital,Yancheng 224000,China)
出处
《山东医药》
CAS
2022年第1期34-38,共5页
Shandong Medical Journal
基金
江苏省卫生计生委医学科研课题(H2018134)。
