血清FGF23、MMP-14、CgA水平与慢性心力衰竭患者心室重构的相关性

Correlation between levels of serum FGF23,MMP-14 and CgA and ventricular remodeling in patients with chronic heart failure

目的观察慢性心力衰竭(CHF)患者心室重构(VR)发生情况及可能因素,分析血清成纤维细胞生长因子23(FGF23)、基质金属蛋白酶-14(MMP-14)、嗜铬粒蛋白A(CgA)表达与VR的关系。方法选取2018年1月至2019年12月于通许第一医院接受治疗的68例CHF患者,依据入是否发生VR,将患者分为发生组和未发生组。比较两组一般资料、实验室指标(血清FGF23、MMP-14、CgA水平)并分析与CHF患者发生VR的关系。结果68例CHF患者中发生VR18例(26.47%);发生组患者血清内皮素(ET)、可溶性Sema4D(sSema4D)、FGF23、MMP-14、CgA水平均高于未发生组,差异有统计学意义(P<0.05),其他基线资料比较差异无统计学意义(P>0.05)。经二元Logistic回归分析后建立多元回归模型结果显示,血清ET、sSema4D、FGF23、MMP-14、CgA过表达是CHF患者发生VR的影响因素(OR>1,P<0.05);受试者工作曲线(ROC)结果显示,血清FGF23、MMP-14、CgA水平单独及联合预测CHF患者VR风险的曲线下面积(AUC)均>0.80,预测价值较理想,且以联合预测效果最佳。结论CHF患者发生VR可能与血清FGF23、MMP-14、CgA过表达有关,通过检测患者相关血清FGF23、MMP-14、CgA表达,预测VR发生风险,以指导早期干预,改善预后。

Objective To observe the incidence of ventricular remodeling(VR)and possible factors,and analyze the correlation between VR and the expressions of fibroblast growth factor 23(FGF23),matrix metalloproteinase-14(MMP-14)and chromogranin A(CgA)in patients with chronic heart failure(CHF).Methods CHF patients(n=68)were chosen from the Tongxu First Hospital from Jan.2018 to Dec.2019,and divided,according to VR incidence,into VR group and non-VR group.The general materials and laboratory indexes(FGF23,MMP-14,CgA)were compared in 2 groups,and relationship between levels of serum FGF23,MMP-14 and CgA and VR incidence were analyzed.Results Among 68 patients,18(26.47%)had VR.The levels of ET,sSema4D,FGF23,MMP-14 and CgA were higher in VR group than those in non-VR group(P<0.05).The difference in other baseline materials had no statistical significance between 2 groups(P>0.05).The results of binary Logistic regression analysis showed that the over-expressions of ET,sSema4D,FGF23,MMP-14 and CgA were influence factors of VR incidence in CHF patients(OR>1,P<0.05).The results of ROC curve analysis showed that AUC of levels of serum FGF23,MMP-14 and CgA in predicting VR risk alone and in combination were all>0.80 in CHF patients.Conclusion The incidence of VR is correlated to over-expressions of FGF23,MMP-14 and CgA.The risk of VR can be predicted through detecting levels of serum FGF23,MMP-14 and CgA to guide early intervention and improve prognosis in CHF patients.