高血压性心脏病患者血清galectin-3、Apelin-12水平变化及其临床意义

Expression and Clinical Significance of Galectin-3 and Apelin-12 in Serum of Patients with Hypertensive Heart Disease

【目的】探讨高血压性心脏病(HHD)患者半乳糖凝集素-3(galectin-3)、孤独G蛋白偶联受体配体-12(Apelin-12)血清水平变化及其临床意义。【方法】选取2019年10月至2021年10月本院收治的160例单纯高血压患者(高血压组),137例HHD患者作为HHD组。比较两组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左心房内径(LAD)、左室射血分数(LVEF)、二尖瓣舒张早期心室血流最大峰值(E峰)、舒张晚期心室血流最大峰值(A峰),并计算E/A;比较galectin-3、Apelin-12水平;采用Pearson检验分析HHD患者血清galectin-3、Apelin-12水平与心脏超声参数相关性;采用受试者工作特征(ROC)曲线评估血清galectin-3、Apelin-12水平对HHD的诊断价值;采用多因素Logistic回归分析影响高血压患者发生HHD的危险因素。【结果】HHD组患者收缩压(SBP)、舒张压(DBP)、LVESD、LVEDD、IVST、LVPWT、LAD及血清galectin-3水平均高于高血压组(P<0.05),高血压病程明显长于高血压组(P<0.05),LVEF、E/A及血清Apelin-12水平明显低于高血压组(P<0.05)。Pearson分析结果显示,HHD患者血清galectin-3水平与LVESD、LVEDD、LAD均呈正相关(P<0.05),与LVEF、E/A均呈负相关(P<0.05),Apelin-12水平与LVESD、LVEDD、LAD均呈负相关(P<0.05),与LVEF、E/A均呈正相关(P<0.05)。galectin-3单独诊断HHD的截断值为7.55 ng/mL,敏感度、特异度分别为67.20%、82.50%;Apelin-12单独诊断HHD的截断值为305.34 ng/L,敏感度、特异度分别为73.70%、71.90%;两者联合诊断的敏感度为76.60%,特异度为80.60%。高血压病程及血清galectin-3、Apelin-12水平是高血压患者发生HHD的影响因素(P<0.05)。【结论】HHD患者血清galectin-3水平升高,Apelin-12水平降低,且两者与左心室结构及功能密切相关。

【Objective】To investigate the serum levels of galectin-3 and Apelin-12 in patients with hypertensive heart disease(HHD)and its clinical significance.【Methods】From October 2019 to October 2021,160 patients with simple hypertension were selected as the hypertension group,and 137 patients with HHD were selected as HHD group.The left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),mitral valvular early diastolic peak velocity(E peak)and mitral valvular end diastolic peak velocity(A peak)were measured,and the E/A was calculated.The enzyme linked immunosorbent assay(ELISA)was used to detect serum levels of galectin-3 and Apelin-12,Pearson test was used to analyze the correlation between serum galectin-3 and Apelin-12 levels and cardiac color Doppler ultrasound parameters in patients with HHD;and receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of serum galectin-3 and Apelin-12 levels in HHD;Multivariate logistic regression model was used to analyze the risk factors of HHD in patients with hypertension.【Results】The systolic blood pressure(SBP),diastolic blood pressure(DBP),LVESD,LVEDD,IVST,LVPWT,LAD and serum galectin-3 level in HHD group were significantly higher than those in hypertension group(P<0.05),and the course of hypertension in HHD group was significantly longer than that in hypertension group(P<0.05).While LVEF,E/A and serum Apelin-12 level in HHD group were significantly lower than those in hypertension group(P<0.05).Pearson analysis showed that serum galectin-3 level was positively correlated with LVESD,LVEDD and LAD(P<0.05),and negatively correlated with LVEF and E/A(P<0.05);Apelin-12 level was negatively correlated with LVESD,LVEDD and LAD(P<0.05),and positively correlated with LVEF and E/A(P<0.05).The cutoff value of galectin-3 was 7.55 ng/mL,and the sensitivity and specificity were 67.20%and 82.50%,respectively,the cutoff value of Apelin-12 was 305.34 ng/L,the sensitivity and specificity were 73.70%and 71.90%,respectively,the sensitivity and specificity of galectin-3 and Apelin-12 combined diagnosis were 76.60%and 80.60%respectively.The course of hypertension and serum levels of galectin-3 and Apelin-12 were independent risk factors for HHD in patients with hypertension(P<0.05).【Conclusion】Galectin-3 is highly expressed in HHD patients,and the expression of Apelin-12 is lowly expressed.They are closely related to the structure and function of left ventricle.