STAT3、MYC与特发性扩张型心肌病患者预后的关系研究

Relationship between STAT3,MYC and Prognosis of Patients with Idiopathic Dilated Cardiomyopathy

目的分析转录激活因子3(STAT3)、髓细胞增生蛋白(MYC)与特发性扩张型心肌病(IDCM)患者预后的关系。方法选取115例IDCM患者,根据其住院期间与随访1年内预后情况分为预后良好组(n=94)与预后不良组(n=21),比较两组临床资料;检测外周血淋巴细胞STAT3、MYC mRNA水平,构建logistic回归模型分析IDCM患者预后影响因素。结果两组性别、年龄、体重指数(BMI)、吸烟史、左心室射血分数(LVEF)、左心室舒张末内径(LVDd)、入院心率(HR)、白蛋白(Alb)、糖尿病、高血压、心房颤动、室性心动过速情况等比较无统计学差异(P>0.05);预后不良组超敏C反应蛋白(hs-CRP)水平显著高于预后良好组(P<0.05);预后不良组STAT3 mRNA、MYC mRNA水平显著低于预后良好组(P<0.05)。Logistic多因素回归分析发现,低水平STAT3 mRNA与MYC mRNA是IDCM患者预后不良的独立危险因素(P<0.05)。结论外周血淋巴细胞STAT3、MYC mRNA水平与IDCM患者预后密切相关,其水平越低,预后不良风险越大。

Objective To analyze the relationship between signal transducer and activator of transcription 3(STAT3),myelocytomatosis protein(MYC)and prognosis in patients with idiopathic dilated cardiomyopathy(IDCM).Methods A total of 115 patients with IDCM in the hospital were enrolled.According to prognosis during hospitalization and 1-year followup,they were divided into good prognosis group(n=94)and poor prognosis group(n=21).The clinical data in the two groups were compared.The mRNA levels of STAT3 and MYC in peripheral blood lymphocytes were detected.The influencing factors of prognosis in IDCM patients were analyzed by Logistic regression model.Results There was no significant difference in gender,age,body mass index(BMI),smoking history,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVDd),heart rate(HR)at admission,albumin(Alb),diabetes mellitus,hypertension,atrial fibrillation or ventricular tachycardia between the two groups(P>0.05).The level of hypersensitive C-reactive protein(hs-CRP)in poor prognosis group was significantly higher than that in good prognosis group(P<0.05),and mRNA levels of STAT3 and MYC were significantly lower than those in good prognosis group(P<0.05).Logistic multivariate regression analysis showed that low levels of STAT3 mRNA and MYC mRNA were independent risk factors of poor prognosis in IDCM patients(P<0.05).Conclusion The mRNA levels of STAT3 and MYC in peripheral blood lymphocytes are closely related to prognosis of IDCM patients.The lower the levels of the two indexes,the higher the risk of poor prognosis.