| 阿尔孜古力·艾尔肯.HIF-1α、S1P与特发性肺动脉高压严重性的相关性及其联合预测对预后的预测价值[J].安徽医药,待发表. |
| HIF-1α、S1P与特发性肺动脉高压严重性的相关性及其联合预测对预后的预测价值 |
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| 投稿时间：2025-04-29 录用日期：2025-06-11 |
| DOI： |
| 中文关键词: The correlation between HIF-1 α, S1P and the severity of idiopathic pulmonary hypertension and their combined predictive value for prognosis |
| 英文关键词: |
| 基金项目:新疆维吾尔自治区自然科学基金资助项目，编号：2021D01C269 |
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| 摘要点击次数: 47 |
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| 中文摘要: |
| 【】目的 分析血清缺氧诱导因子1(hypoxia inducible factor-1,HIF-1α)、1-磷酸鞘氨醇(sphingosine-1-phosphate,S1P)与特发性肺动脉高压严重程度的关系及联合预测不良预后的价值。方法 选择我院自2018年1月至2022年1月确诊的102例特发性肺动脉高压患者作为研究对象,根据预后情况,分为发生临床恶化事件组(CW组)和未发生临床恶化事件组(non-CW组)。比较两组一般资料、肺功能参数、超声心动图指标、经右心导管(RHC)指标、血清HIF-1、S1P水平,多因素Logistic回归分析特发性肺动脉高压预后的独立影响因素,受试者工作特征(ROC)曲线分析HIF-1联合S1P对临床恶化事件的预测效能,Pearson相关性分析HIF-1α、S1P与病情相关指标的相关性。结果 CW组六分钟步行距离试验(6 minute walkingdistance,6MWD)、心输出量(cardiac output,CO)、心脏指数(cardiac index,CI)小于non-CW组,平均肺动脉压(mean pulmonary artery pressure,mPAP)、收缩期肺动脉压力(systolic pulmonary artery pressure,sPAP)、肺血管阻力(pulmonary vascular resistance,PVR)均大于non-CW组,血清HIF-1α、S1P水平高于non-CW组,差异显著(P<0.05)；经多因素Logistic回归分析及校正mPAP、CI后,血清HIF-1α、S1P仍是特发性肺动脉高压患者发生临床恶化事件的独立影响因素(P<0.05)；经Pearson相关性分析,特发性肺动脉高压患者血清HIF-1α与S1P呈正相关(P<0.05),两者均与mPAP呈正相关(P<0.05),与CI呈负相关(P<0.05)；高HIF-1α组临床恶化事件发生率高于低HIF-1α组,mPAP大于低HIF-1α组,CI小于低HIF-1α组,差异均显著(P＜0.05)；高S1P组临床恶化事件发生率高于低S1P组,mPAP大于低S1P组,CI小于低S1P组,差异均显著(P＜0.05)；经ROC曲线分析,血清HIF-1α联合S1P预测特发性肺动脉高压患者发生临床恶化事件的AUC为0.916,大于单项指标HIF-1α的0.603和S1P的0.610,差异均显著(P＜0.05)。结论 血清HIF-1α和S1P与特发性肺动脉高压严重程度呈明显相关,两者联合对预测患者的临床预后具有重要提示意义,值得进一步研究应用。 |
| 英文摘要: |
| 【】Objective To analyze the relationship between serum hypoxia inducible factor-1 (HIF-1α), sphingosine-1-phosphate (S1P) and the severity of idiopathic pulmonary hypertension, and the value of combined prediction of poor prognosis. Methods A total of 102 patients with idiopathic pulmonary hypertension diagnosed in our hospital from January 2018 to January 2022 were selected as the study objects. According to the prognosis, they were divided into clinical worsening event group (CW group) and no clinical worsening event group (non-CW group). The general data, pulmonary function parameters, echocardiographic indicators, right cardiac catheter (RHC) indicators, serum HIF-1 and S1P levels of the two groups were compared, and the independent influencing factors of prognosis of idiopathic pulmonary hypertension were analyzed by multivariate Logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of HIF-1 combined with S1P in clinical worsening events, and Pearson correlation was used to analyze the correlation between HIF-1α, S1P and disease-related indicators. Results The 6 minute walkingdistance test (6MWD), cardiac output (CO) and cardiac index (CI) of the CW group were smaller than those of the non-CW group, mean pulmonary artery pressure (PAP), mean pulmonary artery pressure, mPAP, systolic pulmonary artery pressure (sPAP) and pulmonary vascular resistance (PVR) were all higher than those in non-CW group,serum HIF-1α and S1P levels were higher than those of non-CW group, and the differences were significant (P<0.05).After multivariate Logistic regression analysis and adjustment of mPAP and CI, serum HIF-1α and S1P were still independent influencing factors for clinical worsening events in patients with idiopathic pulmonary hypertension (P<0.05). By Pearson correlation analysis, serum HIF-1α was positively correlated with S1P (P<0.05), both were positively correlated with mPAP (P<0.05), and negatively correlated with CI (P<0.05). The incidence of clinical worsening events in high HIF-1α group was higher than that in low HIF-1α group, mPAP was higher than that in low HIF-1α group, CI was lower than that in low HIF-1α group, and the differences were significant (P < 0.05). The incidence of clinical worsening events in high S1P group was higher than that in low S1P group, mPAP was higher than that in low S1P group, CI was lower than that in low S1P group, and the differences were significant (P < 0.05). According to ROC curve analysis, the AUC of serum HIF-1α combined with S1P in predicting clinical worsening events in patients with idiopathic pulmonary hypertension was 0.916, which was higher than that of single index HIF-1α (0.603) and S1P (0.610), with significant differences (P < 0.05). Conclusion Serum HIF-1α and S1P are significantly correlated with the severity of idiopathic pulmonary hypertension, the combination of HIF-1α and S1P has important significance in predicting the clinical prognosis of patients, and is worthy of further study and application. |
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