国际医药卫生导报2025，Vol.31Issue(11)：1784-1790,7.DOI:10.3760/cma.j.cn441417-20241014-11005
血清TSP-1、Apela水平在冠状动脉粥样硬化性心脏病慢性心力衰竭患者中的表达及意义
Expressions and clinical significance of serum TSP-1 and Apela levels in patients with chronic heart failure secondary to coronary atherosclerotic heart disease
摘要
Abstract
Objective To detect the expressions of serum thrombospondin-1(TSP-1)and Apela in patients with coronary atherosclerotic heart disease(CHD)and chronic heart failure(CHF),and to analyze their clinical significance.Methods 129 patients with CHD combined with CHF who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2023 to January 2024 were selected and included in the CHD+CHF group;129 patients with only CHD without CHF who were admitted during the same period were selected and included in the CHD group;129 healthy subjects who underwent physical examinations during the same period were selected and included in the healthy group.There were 65 males and 64 females in the CHD+CHF group,aged 54-78(66.38±9.10)years,body mass index(BMI)18.09-32.16(23.47±2.97)kg/m2.There were 68 males and 61 females in the CHD group,aged 56-76(67.41±8.67)years,BMI 18.17-31.15(23.39±3.06)kg/m2.There were 63 males and 66 females in the healthy group,aged 54-76(66.95±8.96)years,BMI 18.23-30.96(23.34±3.11)kg/m2.Compare the levels of serum TSP-1 and Apela in 387 subjects;compare the levels of serum TSP-1 and Apela in patients with CHD combined with CHF of different New York Heart Association(NYHA)cardiac function grades;use Pearson correlation analysis method to analyze the correlation between serum TSP-1 and Apela levels and the cardiac function indicators of patients with CHD combined with CHF;follow-up and statistically analyze the prognosis of patients with CHD combined with CHF,divide them into the poor prognosis group(28 cases)and the good prognosis group(91 cases),compare the general data and serum TSP-1 and Apela levels of the two groups;use multivariate logistic regression analysis to analyze the influencing factors of poor prognosis in patients with CHD combined with CHF.Independent sample t test,analysis of variance,LSD-t test,Mann-Whitney U test,and x2 test were used for statistical analysis.Results The serum TSP-1 levels in the CHD group and the CHD+CHF group were both higher than those in the healthy group,while the serum Apela levels were both lower than those in the healthy group(all P＜0.05);the serum TSP-1 level in the CHD+CHF group was higher than that in the CHD group,while the serum Apela level was lower than that in the CHD group(both P＜0.05).The serum TSP-1 levels of patients with grades Ⅲ and grade Ⅳ CHD combined with CHF were higher than those of patients with grade Ⅱ,and the serum Apela levels were lower than those of patients with grade Ⅱ(all P＜0.05);the serum TSP-1 level of patients with grade Ⅳ CHD combined with CHF was higher than that of patients with grade Ⅲ,while the serum Apela level was lower than that of patients with grade Ⅲ(both P＜0.05).The Pearson correlation analysis showed that the serum TSP-1 level was positively correlated with the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic volume(LVEDV),and left ventricular end-systolic volume(LVESV)in patients with CHD combined with CHF,and negatively correlated with the left ventricular ejection fraction(LVEF)(all P＜0.05).The follow-up period was 6 to 18 months,with a median follow-up time of 12 months.Among the 129 patients with CHD and CHF,10 were lost to follow-up,leaving 119 patients.Among them,28 had a poor prognosis(23.53％).The poor prognosis group had higher proportions of smoking,more than 3 diseased blood vessels,irregular medication outside the hospital,as well as higher serum TSP-1 level and Gensini score compared to the good prognosis group[46.43％(13/28)vs.24.18％(22/91),32.14％(9/28)vs.13.19％(12/91),25.00％(7/28)vs.9.89％(9/91),(9.14±2.16)μg/L vs.(7.47±2.02)μg/L,45(31,62)points vs.41(26,58)points](all P＜0.05).The serum Apela level was lower in the poor prognosis group than in the good prognosis group[(2.65±0.68)μg/L vs.(3.48±0.54)μg/L](P＜0.05).The results of multivariate logistic regression analysis showed that smoking(OR=1.687,95％CI 1.007-2.826),high Gensini score(OR=1.864,95％CI 1.200-2.894),high serum TSP-1 level(OR=2.087,95％CI 1.209-3.602),and irregular medication outside the hospital(OR=1.830,95％CI 1.268-2.641)were all independent risk factors for poor prognosis,while high serum Apela level(OR=0.556,95％CI 0.369-0.837)was an independent protective factor(all P＜0.05).Conclusion The serum levels of TSP-1 and Apela in patients with CHD combined with CHF are closely related to cardiac function,and both are influencing factors for the prognosis of patients with CHD combined with CHF.关键词
冠状动脉粥样硬化性心脏病/慢性心力衰竭/血小板反应蛋白1/ApelaKey words
Coronary heart disease/Chronic heart failure/Thrombospondin-1/Apela引用本文复制引用
刘馨玉,石永朋,高渊..血清TSP-1、Apela水平在冠状动脉粥样硬化性心脏病慢性心力衰竭患者中的表达及意义[J].国际医药卫生导报,2025,31(11):1784-1790,7.基金项目
陕西省重点研发计划(S2019-YF-GXYB-0194) Shaanxi Provincial Key Research and Development Program(S2019-YF-GXYB-0194) （S2019-YF-GXYB-0194）
