血清脂蛋白a、凝血酶敏感蛋白-2水平与慢性心力衰竭患者心室重塑的相关性

Correlation between serum Lp(a),TSP-2 levels and ventricular remodeling in patients with chronic heart failure

目的观察血清脂蛋白a[Lp(a)]、凝血酶敏感蛋白-2(TSP-2)在慢性心力衰竭(CHF)患者中表达,并分析二者与CHF患者心室重塑的关系。方法前瞻选取2018年1月至2020年6月三门峡市中心医院心内科接收97例符合条件的CHF患者为研究对象,参照美国纽约心脏病学会(NYHA)心功能分级评估患者病情;询问并记录患者基线资料及实验室指标,重点检测患者入院时心室重塑指标[左心室舒张末内径(LVEDD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室质量指数(LVMI)]及血清Lp(a)、TSP-2水平,分析血清Lp(a)、TSP-2水平与CHF患者心室重塑的关系。结果97例患者经评估,NYHA分级Ⅱ级、Ⅲ级、Ⅳ级患者分别有36例、44例、17例;心功能分级Ⅲ、Ⅳ级的CHF患者LVEDD、IVST、LVPWT、LVMI水平及血清Lp(a)、TSP-2水平均高于Ⅱ级者,且心功能分级Ⅳ级患者各指标水平高于Ⅲ级患者(P<0.05);相关性检验发现,血清Lp(a)、TSP-2水平与CHF患者心室重塑指标(LVEDD、IVST、LVPWT、LVMI)均呈正相关(r>0,P<0.05)。结论CHF患者常伴不同程度心室重塑,血清Lp(a)、TSP-2过表达与CHF心室重塑有关,临床可通过监测血清Lp(a)、TSP-2水平,以评估CHF心室重塑发展状况。

【Objective】 To observe the expression of lipoprotein(a) [Lp(a)] and thrombospondin-2(TSP-2) in patients with chronic heart failure(CHF), and to analyze the relationship between them and ventricular remodeling in patients with CHF.【Methods】 From January 2018 to June 2020, 97 eligible patients with CHF received by the Department of Cardiology of Sanmenxia Central Hospital were prospectively selected as the research subjects, the condition of patients was evaluated according to New York Heart Association(NYHA) cardiac function classification;the baseline data and laboratory parameters of patients were asked and recorded, the indexes of ventricular remodeling [left ventricular end diastolic diameter(LVEDD), interventricular septal thickness(IVST), left ventricular posterior wall thickness(LVPWT), left ventricular mass index(LVMI)] and serum Lp(a), TSP-2 levels of patients at admission were detected, the relationship between serum Lp(a), TSP-2 levels and ventricular remodeling in patients with CHF was analyzed. 【Results】 Of 97 patients after evaluation, there were 36 cases, 44 cases and 17 cases of NYHA grade Ⅱ, Ⅲ and Ⅳ, respectively;the levels of LVEDD, IVST, LVPWT, LVMI and serum Lp(a), TSP-2 in CHF patients with cardiac function grade Ⅲ and Ⅳ were higher than those in CHF patients with cardiac function grade Ⅱ, and the index levels of patients with cardiac function grade Ⅳ were higher than those of patients with cardiac function grade Ⅲ, the difference was statistically significant(P<0.05);correlation test showed that serum Lp(a), TSP-2 levels were positively correlated with ventricular remodeling indexes(LVEDD, IVST, LVPWT, LVMI) in CHF patients(r>0, P<0.05). 【Conclusion】 CHF patients often have different degrees of ventricular remodeling, the overexpression of serum Lp(a) and TSP-2 is associated with ventricular remodeling in CHF, the development of ventricular remodeling in CHF can be evaluated by monitoring serum Lp(a) and TSP-2 levels.