风湿性心脏病患者血清类风湿因子、自噬相关基因7水平与心功能、免疫炎症的关系OACSTPCD
Correlation of serum rheumatoid factor and autophagy-related gene 7 levels with cardiac function and immune inflammation in patients with rheumatic heart disease
目的 探讨类风湿因子(RF)、自噬相关基因 7(Atg7)在风湿性心脏病患者血清中的表达及与心功能、免疫炎症的相关性.方法 选取 2018 年 5 月至 2021 年 5 月长江大学附属仙桃市第一人民医院收治的 102 例风湿性心脏病患者为观察组,并根据纽约心脏协会心功能分级将患者分为Ⅳ级组(34 例)、Ⅲ级组(36 例)、Ⅱ级组(32 例).按照年龄、性别随机选择 100 例健康体检者为对照组.收集一般资料,检测血清RF、Atg7、免疫炎症相关指标水平并进行心脏超声检查.Pearson法分析RF、Atg7 与心功能、免疫炎症指标的相关性.利用ROC曲线评价血清RF、Atg7 水平对风湿性心脏病患者的诊断价值.结果 观察组患者血清中RF、Atg7 表达水平均高于对照组,差异有统计学意义(t=72.872、15.973,均P<0.05);心功能Ⅳ级组和Ⅲ级组患者RF、Atg7、左心室舒张末期内径(LVEDD)水平均高于Ⅱ级患者,左心室射血分数(LVEF)均低于Ⅱ级组患者,差异有统计学意义(P<0.05);心功能Ⅳ级组患者RF、Atg7、LVEDD水平高于Ⅲ级组患者,LVEF低于Ⅲ级组患者,差异有统计学意义(P<0.05);风湿性心脏病患者血清中RF与Atg7表达呈正相关(r=0.463,P<0.05);风湿性心脏病患者血清中RF、Atg7 表达与超敏C反应蛋白、肿瘤坏死因子-α、白介素 6、红细胞沉降率、免疫球蛋白A、免疫球蛋白G、免疫球蛋白M、LVEDD均呈正相关,与LVEF均呈负相关(P<0.05);血清RF、Atg7 水平预测风湿性心脏病患者的ROC曲线下面积分别为0.856(95%CI=0.799～0.901)、0.843(95%CI=0.786～0.890),对应的敏感度分别为 84.31%、86.27%,特异度分别为 89.00%、83.00%.两者联合检测风湿性心脏病患者的ROC曲线下面积为 0.933(95%CI=0.889～0.963),敏感度和特异度分别为 87.25%、86.00%.结论 RF、Atg7在风湿性心脏病患者血清中高表达,与患者心功能及免疫炎症密切相关.
Objective To investigate the expression of rheumatoid factor(RF)and autophagy-related gene 7(Atg7)in the serum of patients with rheumatic heart disease and their correlation with cardiac function and immune inflammation.Methods One hundred and two patients with rheumatic heart disease admitted to Xiantao First People's Hospital Affiliated to Yangtze University,from May 2018 to May 2021 were selected as the observation group.Based on their heart function,patients were classified into grade Ⅳ group(34 cases),grade Ⅲ group(36 cases),and grade Ⅱgroup(32 cases)according to the New York Heart Association(NYHA)classification.One hundred healthy physical examiners matched for age and gender were randomly selected as the control group.General information was collected,and serum levels of RF,Atg7 and immune inflammation markers were detected,along with cardiac ultrasound examinations.Pearson correlation analysis was performed to evaluate the correlation of RF and Atg7 with cardiac function and immune inflammation markers.ROC curve was employed to assess the diagnostic value of serum RF and Atg7 levels in patients with rheumatic heart disease.Results Serum RF and Atg7 expression levels in the observation group were higher than those in the control group,and the differences were statistically significant(t=72.872,15.973;both P<0.05).Patients in grades Ⅳ group and grade Ⅲ group had higher levels of RF,Atg7,and left ventricular end-diastolic diameter(LVEDD)and lower left ventricular ejection fraction(LVEF)compared to grade Ⅱ group,with statistically significant differences(P<0.05).Patients in grades Ⅳ group had higher levels of RF,Atg7 and LVEDD and lower LVEF compared to grade Ⅲ group,and the differences were statistically significant(P<0.05).Serum RF and Atg7 expressions in patients with rheumatic heart disease were positively correlated(r=0.463,P<0.05).Serum RF and Atg7 expressions in patients with rheumatic heart disease were positively correlated with high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin 6(IL-6),erythrocyte sedimentation rate(ESR),immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),and LVEDD,while negatively correlated with LVEF(P<0.05).The areas under the ROC curve of serum RF and Atg7 levels for predicting patients with rheumatic heart disease were 0.856(95%CI=0.799-0.901)and 0.843(95%CI=0.786-0.890),respectively,with corresponding sensitivities of 84.31%and 86.27%,and specificities of 89.00%and 83.00%,respectively.The combined detection of RF and Atg7 in patients with rheumatic heart disease yielded an area under the ROC curve of 0.933(95%CI=0.889-0.963),with sensitivity and specificity of 87.25%and 86.00%,respectively.Conclusion RF and Atg7 are highly expressed in the serum of patients with rheumatic heart disease,and are closely related to cardiac function and immune inflammation.
许文娟;王志为;李德仲;舒品源
433000 仙桃,长江大学附属仙桃市第一人民医院重症医学科
风湿性心脏病类风湿因子自噬相关基因7心功能免疫炎症
Rheumatic heart diseaseRheumatoid factorAutophagy-related gene 7Cardiac functionImmune inflammation
《心脑血管病防治》 2024 (007)
22-26 / 5
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