眼底视网膜病变、沉默信息调节因子4与慢性心力衰竭患者心室重构及心功能的相关性

Correlation between fundus retinopathy,silencing information regulator 4 with ventricular remodeling and cardiac function in patients with chronic heart failure

目的 探讨眼底视网膜病变、沉默信息调节因子4(SIRT4)与慢性心力衰竭(CHF)患者心室重构及心功能的相关性。方法 选择2022年5月至2023年6月河北省廊坊市中医医院收治的198例CHF患者,根据纽约心脏病协会(NYHA)心功能分级将其分为Ⅱ级组(62例),Ⅲ级组(87例),Ⅳ级组(49例)。比较三组Keith-Wagener分级、血清SIRT4水平、左室射血分数(LVEF)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室舒张末期内径(LVEDD)和左心室收缩末期内径(LVESD);分析Keith-Wagener分级、SIRT4与心室重构及心功能的相关性。结果 三组Keith-Wagener分级、血清SIRT4水平比较,差异有统计学意义(P<0.05)。Ⅳ、Ⅲ级组与Ⅱ级组Keith-Wagener分级比较,差异有统计学意义(P<0.05);Ⅳ级组与Ⅲ级组Keith-Wagener分级比较,差异有统计学意义(P<0.05)。Ⅳ、Ⅲ级组血清SIRT4水平高于Ⅱ级组,Ⅳ级组高于Ⅲ级组,差异有统计学意义(P<0.05)。三组左心室重构指标比较,差异有统计学意义(P<0.05)。Ⅳ、Ⅲ级组LVEF低于Ⅱ级组;LVPWT、IVST、LVEDD、LVESD高于Ⅱ级组,差异有统计学意义(P<0.05);Ⅳ级组LVEF低于Ⅲ级组,LVPWT、IVST、LVEDD、LVESD高于Ⅲ级组,差异有统计学意义(P<0.05)。CHF患者Keith-Wagener分级、SIRT4与NYHA分级、LVPWT、IVST、LVEDD、LVESD呈正相关(r_(s)/r>0,P<0.05),与LVEF呈负相关(r<0,P<0.05)。结论 CHF患者存在不同程度眼底视网膜病变,血清SIRT4水平显著增高,且Keith-Wagener分级、SIRT4与左心室重构及心功能分级具有相关性。

Objective To investigate the correlation between fundus retinopathy,silencing information regulator 4(SIRT4)with ventricular remodeling and cardiac function in patients with chronic heart failure(CHF).Methods A total of 198 patients with CHF admitted to Langfang Traditional Chinese Medicine Hospital from May 2022 to June 2023 were selected.According to the New York Heart Association(NYHA)cardiac function grading,they were divided into gradeⅡgroup(62 cases),gradeⅢgroup(87 cases),and gradeⅣgroup(49 cases).Keith-Wagener grading,serum SIRT4 level,left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),left ventricular end-diastolic diameter(LVEDD),and left ventricular end-systolic diameter(LVESD)were compared among three group;the correlation between Keith-Wagener grading,SIRT4 and ventricular remodeling and cardiac function were analyzed.Results There were significant differences in Keith-Wagener grading and serum SIRT4 level among three groups(P<0.05).There were significance differences in Keith-Wagener grading between gradeⅣandⅢgroups and gradeⅡgroup(P<0.05);there was significance difference in Keith-Wagener grading between gradeⅣgroup and gradeⅢgroup(P<0.05).The serum SIRT4 levels in gradeⅣandⅢgroups were higher than those in gradeⅡgroup,and that in gradeⅣgroup was higher than that in gradeⅢgroup,and the differences were statistically significant(P<0.05).There were significant differences in left ventricular remodeling indexes among three groups(P<0.05).LVEF of gradeⅣandⅢgroups were lower than those of gradeⅡgroup;LVPWT,IVST,LVEDD,and LVESD were higher than those in gradeⅡgroup,and the differences were statistically significant(P<0.05);LVEF of gradeⅣgroup was lower than that of gradeⅢgroup,and LVPWT,IVST,LVEDD,and LVESD of gradeⅣgroup was higher than that of gradeⅢgroup,and the differences were statistically significant(P<0.05).Keith-Wagener grading and SIRT4 in CHF patients were positively correlated with NYHA grading,LVPWT,IVST,LVEDD,and LVESD(r_(s)/r>0,P<0.05),and negatively correlated with LVEF(r<0,P<0.05).Conclusion Patients with CHF has different degrees of fundus retinopathy,and serum SIRT4 level is significantly increased,and Keith-Wagener grading and SIRT4 are correlated with left ventricular remodeling and cardiac function grading.