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| 血清CysC IFIT3 ANXA2与老年风湿性心脏病患者心功能相关性分析 |
| Analysis of the correlation between serum CysC IFIT3 ANXA2 and cardiac function in elderly patients with rheumatic heart disease |
| 投稿时间：2025-01-09 |
| DOI：10.3969/j.issn.1000-0399.2025.11.010 |
| 中文关键词: 胱抑素C 具有四肽重复序列3的干扰素诱导蛋白 膜联蛋白A2 老年风湿性心脏病 心功能 |
| 英文关键词: Cystatin C Interferon-induced protein with tetratricopeptide repeat 3 Annexin A2 Elderly rheumatic heart disease Cardiac function |
| 基金项目:河北省中医药管理局科研项目(编号:2025112;2020299) |
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| 中文摘要: |
| 目的 为探究血清胱抑素C（CysC），具有四肽重复序列3的干扰素诱导蛋白（IFIT3），膜联蛋白A2（ANXA2）与老年风湿性心脏病患者心功能的相关性。方法 选取2022年6月～2024年6月在石家庄平安医院就诊的老年风湿性心脏病患者117例作为观察组，另选取同时期在石家庄平安医院体检的健康志愿者117例作为对照组；采用ELISA法检测血清CysC、IFIT3、ANXA2水平；根据《2022年AHA/ACC/HFSA心力衰竭管理指南》将观察组患者心功能及心衰程度分为四个等级，I+II级为心功能良好组（n=84）,III+IV级为心功能不良组（n=33）；采用Pearson法分析观察组血清CysC、IFIT3、ANXA2水平相关性；采用logistic回归分析引起风湿性心脏病患者心功能不良的因素；采用受试者工作特征（ROC）曲线分析血清CysC、IFIT3、ANXA2水平预测老年风湿性心脏病患者发生心功能不良的效能。结果 观察组与对照组间收缩压、舒张压、低密度脂蛋白胆固醇、白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNFα）、白细胞（WBC）水平差异具有统计学意义（P<0.05）；观察组血清CysC、IFIT3、ANXA2水平均高于对照组（P<0.05）；观察组血清CysC、ANXA2水平呈正相关（r=0.453,P<0.001），血清CysC、IFIT3水平呈正相关（r=0.427,P<0.001），血清IFIT3、ANXA2水平呈正相关（r=0.438,P<0.001）；心功能不良组IL-1、IL-6、TNFα、CysC、IFIT3、ANXA2水平均高于心功能良好组（P<0.05）；高水平的CysC、IFIT3、ANXA2是老年风湿性心脏病患者心功能等级为III级+IV级的独立危险因素（P<0.05）；血清CysC、IFIT3、ANXA2水平及三者联合预测患者心功能不良的曲线下面积（AUC）分别为0.630、0.684、0.786、0.841，联合预测患者心功能不良优于单独预测(ZCysC-三者联合=2.784、ZIFIT3-三者联合=2.052、ZANXA2-三者联合=2.055,P=0.005、P=0.040、P=0.039)。结论 本研究发现风湿性心脏病患者血清CysC、IFIT3、ANXA2水平可能随患者心功能降低而升高，这可用于临床辅助评估老年风湿性心脏病患者心功能情况。 |
| 英文摘要: |
| Objective To investigate the correlation between serum cystatin C（CysC）, interferon-induced protein with tetratricopeptide repeat 3（IFIT3）, Annexin A2（ANXA2） with cardiac function in elderly patients with rheumatic heart disease. Methods A total of 117 elderly patients with rheumatic heart disease admitted to Shijiazhuang Ping’an Hospital from June 2022 to June 2024 were recruited as the observation group; meanwhile, 117 healthy volunteers who underwent normal health checkup at Shijiazhuang Ping’an Hospital were regarded as the control group. ELISA method was applied to detect serum levels of CysC, IFIT3, and ANXA2. According to the 2022 AHA/ACC/HFSA Heart Failure Management Guidelines, cardiac function and heart failure severity were separated into four grades, grades I+II were considered as the good cardiac function group（n=84）, while grades III+IV were considered as the poor cardiac function group（n=33）. Pearson method was applied to analyze the correlation between serum CysC, IFIT3, and ANXA2 levels in the observation group. Logistic analysis was applied to analyze the factors causing poor cardiac function in patients with rheumatic heart disease. The ROC curve was applied to analyze the efficacy of serum CysC, IFIT3, and ANXA2 levels in predicting poor cardiac function in elderly patients with rheumatic heart disease. Results There were prominent differences in systolic blood pressure, diastolic blood pressure, low-density lipoprotein cholesterol, IL-1, IL-6, TNFα, and WBC levels between the observation group and the control group（P＜0.05）. The serum levels of CysC, IFIT3, and ANXA2 in the observation group were prominently higher than those in the control group（P＜0.05）. The levels of serum CysC and ANXA2 in the observation group were positively correlated（r=0.453, P＜0.001）, the levels of serum CysC and IFIT3 were positively correlated（r=0.427, P＜0.001）, and the levels of serum IFIT3 and ANXA2 were positively correlated（r=0.438, P＜0.001）. The levels of IL-1, IL-6, TNF α, CysC, IFIT3, and ANXA2 in the poor cardiac function group were prominently higher than those in the good cardiac function group（P＜0.05）. High levels of CysC, IFIT3, and ANXA2 were independent risk factors for cardiac function grade III+IV（P＜0.05）. The area under the curve（AUC） of serum CysC, IFIT3, ANXA2 levels and their combination in predicting poor cardiac function in patients was 0.630, 0.684, 0.786, and 0.841, respectively. Combined prediction was superior to individual prediction for poor cardiac function(ZCysC-triple combination=2.784, ZIFIT3-triple combination=2.052, ZANXA2-triple combination=2.055, P=00.005, P=00.040, P=00.039). Conclusion It is found that serum CysC, IFIT3, and ANXA2 levels in patients with rheumatic heart disease increase as their cardiac function decreases, which can be used for clinical auxiliary assessment of the cardiac function of elderly patients with rheumatic heart disease. |
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