超声心动图参数及HSP70基因多态性与老年慢性心力衰竭预后的相关性分析

Correlation Analysis of Echocardiographic Parameters and HSP70 Gene Polymorphism with the Prognosis of Chronic Heart Failure in the Elderly

目的:分析超声心动图参数、热休克蛋白70(HSP70)基因多态性与老年慢性心力衰竭患者预后的相关性。方法:选取2019年10月至2021年10月于我院治疗的老年慢性心力衰竭患者142例作为研究对象,对其进行1年随访观察,用是否发生心血管事件评估其预后情况,将其分为预后不良组(32例)、预后良好组(110例)。收集患者出院前超声心动图检测参数,采用聚合酶链反应(PCR)结合限制性内切酶分析检测HSP70-1基因+190G/C、HSP70-2基因+1267A/C、HSP70-hom基因+2437T/C多态性,结合患者临床人口学与病理资料,分析两组患者超声心动图参数及HSP70基因多态性差异。采用二元Logistic回归分析老年慢性心力衰竭预后与超声心动图参数及HSP70基因多态性的相关性,建立ROC曲线评估超声心动图参数及HSP70基因多态性预测预后不良的价值。结果:与预后良好组患者相比,预后不良组患者超声心动图参数左心室舒张末期直径(LVEDD)、左心室收缩末期直径(LVESD)均更高(P<0.05),左心室射血分数(LVEF)更低(P<0.05)。与预后良好组患者相比,预后不良组患者HSP70-2基因+1267A/C基因型、等位基因差异有统计学意义(P<0.05)。Logistic回归分析显示年龄、LVEDD、LVEF、HSP70-2基因+1267A/C多态性是预后不良的影响因素(P<0.05)。LVEDD、LVEF、HSP70-2基因+1267A/C多态性单独、联合预测预后不良曲线下面积分别为0.728、0.852、0.624、0.985。结论:LVEDD、LVEF、HSP70-2基因+1267A/C多态性是老年慢性心力衰竭患者预后的影响因素,LVEDD升高,LVEF降低以及GG基因型均可增加老年慢性心力衰竭预后不良风险,三者联合时预测预后不良效能更高。

Objective:To analyze the correlation between echocardiography parameters,heat shock protein 70(HSP70)gene polymorphism and the prognosis of elderly patients with chronic heart failure.Methods:142 elderly patients with chronic heart failure treated in our hospital from October 2019 to October 2021 were selected as the research objects,and were followed up for one year.The prognosis was evaluated by whether cardiovascular events occurred,and the patients were divided into the poor prognosis group(32 cases)and the good prognosis group(110 cases).The echocardiographic parameters of the patients were collected before discharge,and the polymorphisms of HSP70-1 gene+190G/C,HSP70-2 gene+1267A/C,HSP70-hom gene+2437T/C were detected by polymerase chain reaction(PCR)and restriction endonuclease analysis.The differences of echocardiographic parameters and HSP70 gene polymorphisms between the two groups were analyzed based on the clinical demographic and pathological data of the patients.Binary logistic regression analysis was used to analyze the correlation between the prognosis of elderly chronic heart failure and echocardiography parameters and HSP70 gene polymorphism.Results:Compared with the good prognosis group,LVEDD and LVESD of patients in the poor prognosis group were higher,and LVEF was lower(P<0.05).Compared with the good prognosis group,HSP70-2 gene+1267A/C genotype and allele of patients in the poor prognosis group were statistically significant difference(P<0.05).Logistic regression analysis showed that age,LVEDD,LVEF,HSP70-2 gene+1267A/C polymorphism were the factors influencing poor prognosis(P<0.05).The areas under the curve of LVEDD,LVEF and HSP70-2 genes+1267A/C polymorphism alone and jointly predicfing poor prognosis were 0.728,0.852,0.624 and 0.985 respective.Conclusion:LVEDD,LVEF,HSP70-2 gene+1267A/C polymorphisms are factors influencing the prognosis of elderly patients with chronic heart failure.Elevated LVEDD,decreased LVEF,and GG genotype can increase the risk of poor prognosis of elderly patients with chronic heart failure.The combination of the three are more effective in predicting poor prognosis.