老年高血压患者血清sST2、Gal-3、MMP-9表达与左室肥厚的相关性分析

Correlation between serum sST2,Gal-3,and MMP expression and left ventricular hypertrophy in older patients with hypertension

目的探讨老年高血压患者血清可溶性ST2(sST2)、半乳糖凝集素-3(Gal-3)、基质金属蛋白酶-9(MMP-9)表达与左室肥厚发生的相关性。方法选择2019—2021年本院收治的120例老年高血压患者,根据左心室质量指数(LVMI)将患者分为高血压合并左室肥厚组(68例)和单纯高血压组(52例),检测血清sST2、Gal-3、MMP-9水平,多因素logistics回归分析左室肥厚的危险因素,绘制受试者工作特性曲线(ROC)评价上述指标预测老年高血压患者合并左室肥厚的效能。结果合并左室肥厚组血清sST2[(46.89±5.23)ng/mL]、Gal-3[(7.12±1.72)ng/mL]、MMP-9[(319.26±52.36)ng/mL]水平,高于单纯高血压组[(41.98±3.62)ng/mL、(5.28±1.03)ng/mL、(266.35±36.56)ng/mL],差异均有统计学意义(t=3.782、4.477、4.059,P均<0.001)。多因素logistics回归分析显示:高sST2、Gal-3、MMP-9水平为老年高血压患者左室肥厚独立危险因素(P<0.001)。ROC曲线分析显示:血清sST2、Gal-3及MMP-9诊断老年高血压患者合并左室肥厚的AUC均>0.70,且联合检查可提高特异度。当血清sST2、Gal-3与MMP-9的cut-off值分别取43.15、5.56、290.23 ng/mL时,可获得最佳诊断价值。单个sST2、Gal-3、MMP-9检测时,68例合并左室肥厚组检出阳性48、53、50,52例单纯高血压组检出阳性25、31、28例;三者联合检测时,合并左室肥厚组、单纯高血压组检出阳性56、34例,差异均有统计学意义(P<0.05)。结论老年高血压患者血清sST2、Gal-3、MMP-9水平明显增高与左室肥厚有良好相关性,早期监测有利于左室肥厚的预防和诊断。

Objective This study investigated the correlation between serum soluble ST2(sST2),galactose lectin 3(Gal-3),and matrix metalloproteinase-9(MMP-9)expression and left ventricular hypertrophy in older patients with hypertension.Methods A total of 120 older patients with hypertension admitted to our hospital between January 2019 and December 2021 were selected.According to left ventricular mass index(LVMI),the patients were divided into a hypertension with left ventricular hypertrophy group(68 cases)and simple hypertension group(52 cases).The serum levels of sST2,Gal-3,and MMP-9 were measured.The risk factors for left ventricular hypertrophy were analyzed through multivariate logistic regression,and the receiver operating characteristic curve(ROC)was plotted to evaluate the efficacy of these indexes in predicting left ventricular hypertrophy in older hypertensive patients.Results The serum sST2,Gal-3,and MMP-9 levels in patients with left ventricular hypertrophy were significantly higher than those in patients with simple hypertension(t=3.782,4.477,4.059,all P<0.001).Multivariate logistic regression analysis showed that high levels of sST2,Gal-3,and MMP-9 were independent risk factors for left ventricular hypertrophy in older hypertensive patients(P<0.001).ROC curve analysis indicated that the AUC of serum sST2,Gal-3,and MMP-9 in the diagnosis of older hypertensive patients with left ventricular hypertrophy exceeded 0.70,and the combined examination improved the specificity.Thebest diagnostic value was obtained with the cutoff values of serum sST2,Gal-3,and MMP-9 of 43.15 ng/mL,5.56 ng/mL,and 290.23 ng/mL,respectively.When single sST2,Gal-3,and MMP-9 were detected,48,53,and 50 cases were identified among 68 patients with left ventricular hypertrophy,and 25,31,and 28 cases were identified among 52 patients with simple hypertension.In the combined examination of the three indexes,56 cases in the group with left ventricular hypertrophy and 34 cases in the group with simple hypertension were identified,and the difference was statistically significant(P<0.05).Conclusions The serum levels of sST2,Gal-3,and MMP-9 in older patients with hypertension are significantly elevated and correlate well with left ventricular hypertrophy.Early monitoring is conducive to the prevention and diagnosis of left ventricular hypertrophy.