Diagnostic Value of Echocardiography Combined with Serum Concentrations of Thrombospondin-1 and Chitinase Protein 40 in Patients with Hypertensive Heart Disease
Diagnostic Value of Echocardiography Combined with Serum Concentrations of Thrombospondin-1 and Chitinase Protein 40 in Patients with Hypertensive Heart Disease
石媛媛 1苟龑 1阚平英1
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作者信息
1. 四川友谊医院超声科,成都 610000
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摘要
目的 分析超声心动图联合血清凝血酶敏感蛋白1(thrombospondin-1,TSP-1)、甲壳质酶蛋白40(chitinase protein 40,YKL-40)浓度检测对高血压性心脏病患者的诊断价值.方法 选择2021年1月至2022年6月四川友谊医院收治的高血压性心脏病患者98例(心脏病组)进行研究,患者入组均接受超声心动图检查.酶联免疫吸附测定法(enzyme-linked immunosorbent assay,ELISA)检测血清TSP-1、YKL-40浓度.Pearson法分析高血压性心脏病患者血清TSP-1、YKL-40浓度与超声心动图各项参数的相关性,采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评估血清TSP-1、YKL-40浓度诊断高血压性心脏病的可靠性.结果 与对照组相比,心脏病组患者的收缩压、舒张压、左心房前后直径(left atrial anteroposterior diameter,LAD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)、左心房内径指数(left atrial inner diameter index,LADI)、室间隔舒张末期厚度(end-diastolic interventricular septum thickness,IVST)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心室后壁舒张末期厚度(left ventricular posterior wall end-diastolic thickness,LVPWT)、左心室舒张晚期峰值流速(diastolic advanced stage filling peak rate of flow,VA)值较高,二尖瓣血流舒张早期左心室充盈峰速(peak velocity of left ventricular filling during early diastole,VE)值、峰值速度比率(ratio of E velocity to A velocity,E/A)较低,差异有统计学意义(P<0.05).与对照组相比,心脏病组患者血清TSP-1、YKL-40 浓度较高,差异有统计学意义(P<0.05).Pearson法分析显示,血清TSP-1、YKL-40 浓度与LAD、LVESD、LADI、IVST、LVEDD、LVPWT、VA值均呈正相关(P<0.05),与VE值、E/A均呈负相关(P<0.05).超声心动图评估患者发生高血压性心脏病的准确度为88.00%,血清TSP-1、YKL-40浓度对高血压性心脏病诊断的准确度为81.00%、82.50%.超声心动图联合血清TSP-1、YKL-40浓度对高血压性心脏病诊断的准确度为91.50%,其灵敏度为95.92%,特异度为87.25%.结论 高血压性心脏病患者血清中TSP-1、YKL-40浓度升高,血清TSP-1、YKL-40浓度对高血压性心脏病有一定诊断价值,超声心动图联合血清TSP-1、YKL-40浓度可明显提高高血压性心脏病诊断的准确性.
Abstract
Objectives To analyze the diagnostic value of echocardiography combined with serum concentrations of thrombospondin-1(TSP-1)and chitinase protein 40(YKL-40)in patients with hypertensive heart disease.Methods A total of 98 patients with hypertensive heart disease admitted to Sichuan Friendship Hospital from January 2021 to June 2022(heart disease group)were selected,and 102 patients with hypertension and no structural heart damage admitted during the same period were selected as control group.All the enrolled patients received echocardiography.Serum concen-trations of TSP-1 and YKL-40 were detected by enzyme-linked immunosorbent assay.Pearson method was used to analyze the correlation between serum concentrations of TSP-1 and YKL-40 and echocardiographic parameters in patients with hypertensive heart disease,and receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of serum concentrations of TSP-1 and YKL-40 in patients with hypertensive heart disease.Results Compared to control group,systolic blood pressure,diastolic blood pressure,left atrial anteroposterior diameter(LAD),left ventricular end systolic diameter(LVESD),left atrial inner diameter index(LADI),ventricular end-diastolic interventricular septum thickness(IVST),left ventricular end diastolic diameter(LVEDD),left ventricular posterior wall end-diastolic thick-ness(LVPWT)and diastolic advanced stage filling peak rate of flow(VA)values in heart disease group were significantly higher(P<0.05),peak velocity of left ventricular filling during early diastole(VE)values and ratio of E velocity to A velocity(E/A)were significantly lower(P<0.05).Compared with control group,the serum concentrations of TSP-1 and YKL-40 in heart disease group were obviously higher(P<0.05).Pearson analysis showed that serum concentrations of TSP-1 and YKL-40 were positively correlated with LAD,LVESD,LADI,IVST,LVEDD,LVPWT and VA values(P<0.05),and negatively correlated with VE and E/A values(P<0.05).The accuracy of echocardiography in the diagnosis of hypertensive heart disease was 88.00%,the accuracy of serum concentrations of TSP-1 and YKL-40 in the diagnosis of hypertensive heart disease was 81.00%and 82.50%.The accuracy,sensitivity and specificity of echocardiography com-bined with serum concentrations of TSP-1 and YKL-40 in the diagnosis of hypertensive heart disease were 91.50%,95.92%and 87.25%.Conclusions Serum concentrations of TSP-1 and YKL-40 increased in patients with hypertensive heart disease.Serum concentrations of TSP-1 and YKL-40 have certain diagnostic value for hypertensive heart disease.Echocardiography combined with serum concentrations of TSP-1 and YKL-40 can significantly improve the diagnostic accuracy of hypertensive heart disease.
关键词
高血压性心脏病/超声心动图/凝血酶敏感蛋白1/甲壳质酶蛋白40/诊断价值
Key words
hypertensive heart disease/echocardiography/thrombospondin-1/chitinase protein 40/diagnostic value
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