| 原涛,任丽玮,王学智,等.老年慢性心力衰竭病人血清热休克蛋白 90水平及其与心功能和预后的关系[J].安徽医药,2025,29(3):546-550. |
| 老年慢性心力衰竭病人血清热休克蛋白 90水平及其与心功能和预后的关系 |
| The relationship between serum heat shock protein 90 level and cardiac function and prognosis in elderly patients with chronic heart failure |
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| DOI：10.3969/j.issn.1009-6469.2025.03.022 |
| 中文关键词: 心力衰竭 热休克蛋白 90 心功能 预后 老年人 |
| 英文关键词: Heart failure Heat shock protein 90 Cardiac function Prognosis Aged |
| 基金项目:邯郸市科学技术研究与发展计划项目( 21422083061) |
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| 中文摘要: |
| 目的研究老年慢性心力衰竭病人血清热休克蛋白 90(Hsp90)表达水平及其与病人心功能和预后的关系。方法收集 2020年 1月至 2021年 12月在邯郸市第一医院接受治疗的 108例老年慢性心力衰竭病人为研究组，以同时间 100例体检者为对照组。将研究组根据美国纽约心脏病学会( NYHA)的标准，分为 Ⅱ级组 31例、 Ⅲ级组 42例和 Ⅳ级组 35例。另外依据病人出院后半年随访结果，分为预后良好组( 65例)和预后不良组( 43例)。通过酶联免疫吸附测定( ELISA)检测血清 Hsp90表达水平；使用超声诊断仪测定左心室收缩末期内径( LVESD)、左心室舒张末期内径( LVEDD)以及左心室射血分数( LVEF)；分析 Hsp90表达水平与心功能指标的关系，及其对慢性心力衰竭预后的预测价值。结果研究组血清 Hsp90［(1.45±0.35)μg/L比(0.36±0.10)μg/L］、 LVESD和 LVEDD较对照组显著升高， LVEF较对照组显著降低( P<0.05)。随着心功能分级的增加，血清 Hsp90、LVESD和 LVEDD增加， LVEF降低，且各组间比较差异有统计学意义( P<0.05)。慢性心力衰竭病人血清 Hsp90表达水平与 LVESD和 LVEDD呈正相关( r=0.58、0.56，P<0.05)与 LVEF呈负相关( r=.0.60，P<0.05)。预后不良组血清 Hsp90、LVESD和 LVEDD较预后良好组升高， LVEF较预后良好组降P<0.05)。血清 Hsp90评估慢性心力衰竭病人预后的最佳截断值为 低(1.46 μg/L，曲线下面积(AUC)为 0.80，灵敏度为 83.70%，特异度为 76.90%。结论血清中 Hsp90表达水平在老年慢性心力衰竭病人中显著升高，与病人心功能和预后密切相关，血清 Hsp90水平越高，心功能损伤越严重，病人的预后越差，且 Hsp90水平对老年慢性心力衰竭病人的预后具有一定的预测价值。 |
| 英文摘要: |
| Objective To study the expression level of serum heat shock protein 90 (Hsp90) in elderly patients with chronic heart fail-ure, and its relationship with cardiac function and prognosis.Methods A total of 108 elderly patients with chronic heart failure whowere treated in The First Hospital of Handan from January 2020 to December 2021 were enrolled as the research group, and 100healthy subjects having a physical examination at the same time were enrolled as the control group. According to the New York HeartAssociation (NYHA) criteria, the study group was assigned into grade Ⅱ group (n=31), grade Ⅲ group (n=42), and grade Ⅳ group (n= 35). In addition, according to the results of follow-up half a year after discharge, the patients were assigned into good prognosis group (n =65) and poor prognosis group (n=43). The expression level of serum Hsp90 was detected by enzyme-linked immunosorbent assay (ELI-SA); left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD) and the left ventricular ejectionfraction (LVEF) were measured by ultrasonic diagnostic equipment. The correlation between the expression level of Hsp90 and cardiacfunction indexes, and its predictive value for the prognosis of chronic heart failure were analyzed.Results Serum Hsp90 [(1.45±0.35) μg/L vs. (0.36±0.10) μg/L], LVESD and LVEDD in the study group were significantly higher than those in the control group, whileLVEF was significantly lower than that in the control group (P<0.05). With the increase in cardiac function grade, Serum Hsp90,LVESD and LVEDD increased, while LVEF decreased, and the difference between the groups was statistically significant (P<0.05).The expression level of Hsp90 in serum of patients with chronic heart failure was positively correlated with LVESD and LVEDD (r= 0.58, 0.56, P<0.05), and negatively correlated with LVEF (r=.0.60, P<0.05). The serum Hsp90, LVESD and LVEDD in the poor prog-nosis group were higher than those in the good prognosis group, and LVEF was lower than that in the good prognosis group (P<0.05). The optimal cut-off value of serum Hsp90 for evaluating the prognosis of patients with chronic heart failure was 1.46 μg/L, the area un-der the curve (AUC) was 0.80, the sensitivity was 83.70%, and the specificity was 76.90%. Conclusions The expression level ofHsp90 in the serum of elderly patients with chronic heart failure is obviously increased, which is closely related to the cardiac functionand prognosis of the patients. The higher the serum Hsp90 level, the more serious the cardiac function injury, and the worse the progno-sis of patients, and the level of Hsp90 has a certain predictive value for the prognosis of elderly patients with chronic heart failure. |
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