冠心病伴心力衰竭患者血清Periostin蛋白水平变化及临床意义

Changes and clinical significance of serum Periostin level in patients with coronary heart disease complicated by heart failure

目的探讨冠状动脉粥样硬化性心脏病(冠心病)伴心力衰竭患者血清Periostin蛋白水平变化及临床意义。方法选取2017年1月至2018年6月期间于广西科技大学附属柳州市人民医院心内科就诊的冠心病伴心力衰竭患者103例作为研究组,根据美国纽约心脏病协会(NYHA)分级标准进行分组,其中Ⅱ级30例,Ⅲ级35例,Ⅳ级38例,选取同期在我院进行治疗的单纯冠心病患者50例作为冠心病组,另外选取同期我院的健康体检者50例作为对照组。比较各组研究对象的Periostin蛋白、N端脑钠肽前体(NT-proBNP)、转化生长因子-β1(TGF-β1)、左室舒张末期内径(LVEDD)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、左心室重量指数(LVMI),分析冠心病伴心力衰竭患者血清Periostin蛋白水平与相关指标的相关性。结果研究组Periostin蛋白、NT-proBNP、TGF-β1水平以及LVEDD、LVEDV、LVMI高于冠心病组和对照组,LVEF低于冠心病组和对照组(P<0.05),冠心病组的Periostin蛋白、NT-proBNP、TGF-β1水平以及LVEDD、LVEDV、LVMI高于对照组,LVEF低于对照组(P<0.05)。Periostin蛋白、NT-proBNP、TGF-β1、LVEDD、LVEDV、LVMI水平随患者心功能分级的增加而升高,而LVEF水平随患者心功能分级的增加而降低(P均<0.05)。冠心病伴心力衰竭患者血清Periostin蛋白水平与NT-proBNP、TGF-β1、LVEDD、LVEDV、LVMI呈正相关(r=0.394,0.721,0.426,0.473,0.319,P<0.05),与LVEF呈负相关(r=-0.386,P<0.05)。结论冠心病伴心力衰竭患者血清中的Periostin蛋白水平与患者的心脏重构和心功能密切相关。

Objective To investigate the changes and clinical significance of serum Periostin level in patients with coronary heart disease(CHD) complicated by heart failure. Methods CHD patients complicated by heart failure(n=103) were chosen into study group from Department of Cardiology of Liuzhou people’s Hospital Affiliated to Guangxi University of science and technology from Jan. 2017 to June 2018. And they were divided,according to NYHA classification of heart function, into grade Ⅱ subgroup(n=30), grade Ⅲ subgroup(n=35) and grade Ⅳ subgroup(n=38). At the same time CHD patients(n=50) treated in People’s Hospital of Liuzhou City were chosen into CHD group and healthy controls(n=50) were chosen into control group. The levels of Periostin,N-terminal pro-brain natriuretic peptide(NT-proBNP), transforming growth factor β1(TGF-β1), left ventricular end-diastolic inner diameter(LVEDd), left ventricular end-diastolic volume(LVEDV), left ventricular ejection fraction(LVEF) and left ventricular mass index(LVMI) were compared among all groups. The correlation between Periostin level and relevant indexes was analysis. Results The levels of Periostin, NT-proBNP, TGF-β1,LVEDD, LVEDV and LVMI were higher, and level of LVEF was lower in study group than those in CHD group and control group(P<0.05). The levels of Periostin, NT-proBNP, TGF-β1, LVEDD, LVEDV and LVMI were higher, and level of LVEF was lower in CHD group than those in control group(P<0.05). The levels of Periostin,NT-proBNP, TGF-β1, LVEDD, LVEDV and LVMI increased along with the increase of NYHA classification of heart function, and level of LVEF decreased along with the increase of NYHA classification of heart function(all P<0.05). The level of Periostin was positively correlated to NT-proBNP(r=0.394), TGF-β1(r=0.721), LVEDD(r=0.426), LVEDV(r=0.473) and LVMI(r=0.319, P<0.05), and negatively correlated to LVEF(r=-0.386, P<0.05).Conclusion The level of serum Periostin is closely correlated to cardiac remodeling and heart function in patients with CHD complicated by heart failure.