论文部分内容阅读
目的探讨缺血性心力衰竭患者热休克蛋白70(heat shock protein 70,HSP70)水平变化及临床意义。方法缺血性心力衰竭患者193例,其中NYHA心功能Ⅰ+Ⅱ级87例为Ⅰ+Ⅱ级组,Ⅲ+Ⅳ级106例为Ⅲ+Ⅳ级组,同期体检健康者122例为对照组,测定3组舒张压、血清HSP70、C-反应蛋白(C-reactive protein,CRP)、N末端B型脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、空腹血糖(fasting plasma glucose,FPG)、三酰甘油(triacylglycerol,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、尿酸(uric acid,UA)、谷丙转氨酶(glutamic pyruvic transaminase,GPT)、谷草转氨酶(glutamic oxaloacetic transaminase,GOT)水平,超声心动图测定左室射血分数(left ventricular ejection fraction,LVEF),并进行比较。结果Ⅲ+Ⅳ级组FPG水平[(8.4±2.2)mmol/L]高于Ⅰ+Ⅱ级组和对照组[(6.8±1.8)、(4.1±0.8)mmol/L],LVEF[(34.0±5.6)%]、舒张压[(60.0±6.8)mm Hg]低于Ⅰ+Ⅱ级组[(40.0±3.4)%、(70.0±8.9)mm Hg]和对照组[(58.0±7.2)%、(78.0±11.2)mm Hg](P<0.05),Ⅰ+Ⅱ级组FPG水平高于对照组,舒张压、LVEF水平低于对照组(P<0.05);Ⅲ+Ⅳ级组、Ⅰ+Ⅱ级组LDL-C水平[(2.7±0.8)、(2.5±0.7)mmol/L]高于对照组[(2.0±0.5)mmol/L](P<0.05),Ⅲ+Ⅳ级组与Ⅰ+Ⅱ级组比较差异无统计学意义(P>0.05);3组血清TG、UA、GPT、GOT水平比较差异均无统计学意义(P>0.05);血清HSP70、CRP、NT-proBNP水平在Ⅲ+Ⅳ级组[(13.17±5.58)μg/L、(16.96±6.80)mg/L、(5 198.38±1 200.25)ng/L]明显高于Ⅰ+Ⅱ级组[(10.48±4.02)μg/L、(9.25±3.24)mg/L、(2 400.45±468.19)ng/L]和对照组[(6.04±2.50)μg/L、(3.21±1.26)mg/L、(108.47±61.70)ng/L](P<0.05),且Ⅰ+Ⅱ级组高于对照组(P<0.05)。结论不同NYHA心功能分级患者LVEF及血清FPG、HSP70、CRP、NT-proBNP水平存在明显差异,HSP70水平可较好反映缺血性心力衰竭患者病情严重程度。
Objective To investigate the changes of heat shock protein 70 (HSP70) in patients with ischemic heart failure and its clinical significance. Methods A total of 193 patients with ischemic heart failure were enrolled. Among them, 87 patients with NYHA cardiac function Ⅰ + Ⅱ grade Ⅰ + Ⅱ group, 106 patients with Ⅲ + Ⅳ grade Ⅲ + Ⅳ grade group, 122 healthy subjects in the same period as control group, The diastolic blood pressure, serum HSP70, C-reactive protein (CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), fasting plasma glucose (FPG), triacylglycerol (TG), low density lipoprotein-cholesterol (LDL-C), uric acid (UA), glutamic pyruvic transaminase (GPT) , Glutamic oxaloacetic transaminase (GOT), and left ventricular ejection fraction (LVEF) by echocardiography. Results The level of FPG in group Ⅲ + Ⅳ was significantly higher than that in group Ⅰ + Ⅱ [(6.8 ± 1.8), (4.1 ± 0.8) mmol / L] and (34 ± ± (40.0 ± 3.4)%, (70.0 ± 8.9) mm Hg] and control group [(58.0 ± 7.2)%, respectively] and diastolic pressure (60.0 ± 6.8 mm Hg) (78.0 ± 11.2) mm Hg] (P <0.05). The levels of FPG in Ⅰ + Ⅱ group were higher than those in control group, and the levels of diastolic blood pressure and LVEF were lower than those in control group (P <0.05) The level of LDL-C in group Ⅲ was significantly higher than that in control group [(2.7 ± 0.8), (2.5 ± 0.7) mmol / L] and (2.0 ± 0.5) mmol / L in control group (P> 0.05). There was no significant difference in TG, UA, GPT and GOT levels between the three groups (P> 0.05). Serum levels of HSP70, CRP and NT-proBNP were not significantly different between the two groups (13.17 ± 5.58) μg / L, (16.96 ± 6.80) mg / L and (5 198.38 ± 1 200.25) ng / L] were significantly higher than those in the group Ⅰ + Ⅱ [(10.48 ± 4.02) μg / L, (9.25 ± 3.24) mg / L and (2 400.45 ± 468.19) ng / L, respectively) and control group (6.04 ± 2.50 μg / L and 3.21 ± 1.26 mg / L] (P <0.05), and Ⅰ + Ⅱ group than the control group (P <0.05). Conclusions The levels of LVEF, serum FPG, HSP70, CRP and NT-proBNP in patients with NYHA classifications are significantly different. HSP70 level can better reflect the severity of patients with ischemic heart failure.