老年高血压患者血清半乳糖凝集素-3、胱抑素-C和内皮素-1水平表达及与左室肥厚的相关性分析

Expression of serum galectin-3,cystatin-C and endothelin-1 in elderly patients with hypertension and their correlation with left ventricular hypertrophy

目的探讨老年高血压患者血清半乳糖凝集素-3(Gal-3)、胱抑素-C(Cys-C)和内皮素-1(ET-1)水平变化,分析其与左室肥厚(LVH)的相关性。方法选取辽宁省铁岭市中心医院2018年7月至2019年5月收治的110例年龄大于65岁的老年原发性高血压患者(高血压组),根据有无LVH分为非LVH组(66例)及LVH组(44例),选取同期110例健康体检者作为对照组。比较各组血清Gal-3、Cys-C和ET-1水平,分析原发性高血压患者左室质量指数(LVMI)与Gal-3、Cys-C和ET-1的相关性。采用受试者工作特征(ROC)曲线评估Gal-3、Cys-C和ET-1水平对高血压LVH的诊断价值。结果高血压组Gal-3、Cys-C和ET-1水平高于对照组[(132.28±38.18)μg/L比(110.60±17.51)μg/L、(1.19±0.12)mg/L比(0.81±0.06)mg/L、(21.28±0.72)ng/L比(16.50±0.68)ng/L],差异有统计学意义(P<0.05)。LVH组Gal-3、Cys-C和ET-1水平高于非LVH组[(159.75±36.37)μg/L比(113.96±26.79)μg/L、(1.24±)mg/L比(1.16±0.08)mg/L、(21.84±0.71)ng/L比(20.90±0.41)ng/L],差异有统计学意义(P<0.05)。Pearson相关分析表明,高血压患者LVMI与Gal-3(r=0.650,P<0.01)、Cys-C(r=0.659,P<0.01)和ET-1(r=0.858,P<0.01)呈正相关。ROC曲线分析显示,Gal-3水平诊断高血压LVH的曲线下面积(AUC)为0.821,95 CI 0.743~0.899,截断值为148.55μg/L,灵敏度、特异度为59.10%、89.40%;Cys-C诊断高血压LVH的AUC为0.672,95%CI 0.558~0.786,截断值为1.320 mg/L,灵敏度、特异度为43.20%、98.50%;ET-1诊断高血压LVH的AUC为0.876,95%CI 0.811~0.941,截断值为22.275 ng/L,灵敏度、特异度为65.90%、95.50%;联合检测诊断高血压LVH的AUC为0.948,95%CI 0.855~0.976,灵敏度、特异度为84.10%、98.50%。结论老年高血压患者血清Gal-3、Cys-C和ET-1水平显著升高,且与LVH有良好的相关性,联合检测可作为诊断高血压LVH的敏感指标。

Objective To investigate the expression of serum galectin-3(Gal-3),cystatin-C(Cys-C)and endothelin-1(ET-1)in elderly patients with hypertension and analyze their correlation with left ventricular hypertrophy(LVH).Methods A total of over 65 years old 110 patients with essential hypertension in Tieling Central Hospital from July 2018 to May 2019 were selected as hypertension group,according to the LVH,patients with essential hypertension were divided into(non LVH group,66 patients)and LVH group(44 patients).At the same time,a total of 110 healthy people in the same period were selected as control group.The expressions of serum Gal-3,Cys-C and ET-1 in each group were compared,and the correlation between left ventricular mass index(LVMI)and Gal-3,Cys-C in patients with essential hypertension were analyzed.Results The levels of Gal-3,Cys-C and ET-3 in the hypertension group were higher than those in the control group:(132.28±38.18)μg/L vs.(110.60±17.51)μg/L,(1.19±0.12)mg/L vs.(0.81±0.06)mg/L,(21.28±0.72)ng/L vs.(16.50±0.68)ng/L,and the differences were statistically significant(P<0.05).The levels of Gal-3,Cys-C and ET-1 in the LVH group were significantly higher than those in the non LVH group:(159.75±36.37)μg/L vs.(113.96±26.79)μg/L,(1.24±)mg/L vs.(1.16±0.08)mg/L,(21.84±0.71)ng/L vs.(20.90±0.41)ng/L,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that LVMI was positively correlated with Gal-3(r=0.650,P<0.01),Cys-C(r=0.659,P<0.01)and ET-1(r=0.858,P<0.01).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of Gal-3 in diagnosing hypertensive LVH was 0.821,95%CI 0.743-0.899,the cutoff value was 148.55μg/L,and the sensitivity and specificity were 59.10%and 89.40%.The AUC of Cys-C in diagnosing hypertensive LVH was 0.672,95%CI 0.558-0.786,the cutoff value was 1.320 mg/L,and the sensitivity and specificity were 43.20%and 98.50%.The AUC of ET-1 in diagnosing hypertensive LVH was 0.876,95%CI 0.811-0.941,the cutoff value was 22.275 ng/L,and the sensitivity and specificity were 65.90%and 95.50%.The AUC of combined detection was 0.948,95%CI 0.855-0.976,and the sensitivity and specificity were 84.10%,98.50%.Conclusions The serum levels of Gal-3,Cys-C and ET-1 in elderly patients with hypertension are significantly increased,and there are a good correlation between them and LVH,and combined detection can be used as a sensitive index for the diagnosis of hypertensive LVH.