摘要
目的 探讨眼底视网膜病变、沉默信息调节因子4(SIRT4)与慢性心力衰竭(CHF)患者心室重构及心功能的相关性.方法 选择2022年5月至2023年6月河北省廊坊市中医医院收治的198例CHF患者,根据纽约心脏病协会(NYHA)心功能分级将其分为Ⅱ级组(62例),Ⅲ级组(87例),Ⅳ级组(49例).比较三组Keith-Wagener分级、血清SIRT4水平、左室射血分数(LVEF)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室舒张末期内径(LVEDD)和左心室收缩末期内径(LVESD);分析Keith-Wagener分级、SIRT4与心室重构及心功能的相关性.结果 三组Keith-Wagener分级、血清SIRT4水平比较,差异有统计学意义(P＜0.05).Ⅳ、Ⅲ级组与Ⅱ级组Keith-Wagener分级比较,差异有统计学意义(P＜0.05);Ⅳ级组与Ⅲ级组Keith-Wagener分级比较,差异有统计学意义(P＜0.05).Ⅳ、Ⅲ级组血清SIRT4水平高于Ⅱ级组,Ⅳ级组高于Ⅲ级组,差异有统计学意义(P＜0.05).三组左心室重构指标比较,差异有统计学意义(P＜0.05).Ⅳ、Ⅲ级组LVEF低于Ⅱ级组;LVPWT、IVST、LVEDD、LVESD高于Ⅱ级组,差异有统计学意义(P＜0.05);Ⅳ级组LVEF低于Ⅲ级组,LVPWT、IVST、LVEDD、LVESD 高于 Ⅲ级组,差异有统计学意义(P＜0.05).CHF 患者 Keith-Wagener 分级、SIRT4 与 NYHA分级、LVPWT、IVST、LVEDD、LVESD呈正相关(r/r＞0,P＜0.05),与LVEF呈负相关(r＜0,P＜0.05).结论 CHF患者存在不同程度眼底视网膜病变,血清SIRT4水平显著增高,且Keith-Wagener分级、SIRT4与左心室重构及心功能分级具有相关性.
Abstract
Objective To investigate the correlation between fundus retinopathy,silencing information regulator 4(SIRT4)with ventricular remodel-ing and cardiac function in patients with chronic heart failure(CHF).Methods A total of 198 patients with CHF admitted to Langfang Traditional Chi-nese Medicine Hospital from May 2022 to June 2023 were selected.According to the New York Heart Association(NYHA)cardiac function grading,they were divided into grade Ⅱ group(62 cases),grade Ⅲ group(87 cases),and grade Ⅳ group(49 cases).Keith-Wagener grading,serum SIRT4 lev-el,left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),left ventricular end-diastolic diameter(LVEDD),and left ventricular end-systolic diameter(LVESD)were compared among three group;the correlation between Kei-th-Wagener grading,SIRT4 and ventricular remodeling and cardiac function were analyzed.Results There were significant differences in Keith-Wa-gener grading and serum SIRT4 level among three groups(P＜0.05).There were significance differences in Keith-Wagener grading between grade Ⅳand Ⅲ groups and grade Ⅱ group(P＜0.05);there was significance difference in Keith-Wagener grading between grade Ⅳ group and grade Ⅲ group(P＜0.05).The serum SIRT4 levels in grade Ⅳ and Ⅲ groups were higher than those in grade Ⅱ group,and that in grade Ⅳ group was higher than that in grade Ⅲ group,and the differences were statistically significant(P＜0.05).There were significant differences in left ventricular remodeling indexes among three groups(P＜0.05).LVEF of grade Ⅳ and Ⅲ groups were lower than those of grade Ⅱ group;LVPWT,IVST,LVEDD,and LVESD were higher than those in grade Ⅱ group,and the differences were statistically significant(P＜0.05);LVEF of grade Ⅳ group was lower than that of gradeⅢ group,and LVPWT,IVST,LVEDD,and LVESD of grade Ⅳ group was higher than that of grade Ⅲ group,and the differences were statistically sig-nificant(P＜0.05).Keith-Wagener grading and SIRT4 in CHF patients were positively correlated with NYHA grading,LVPWT,IVST,LVEDD,and LVESD(rs/r＞0,P＜0.05),and negatively correlated with LVEF(r＜0,P＜0.05).Conclusion Patients with CHF has different degrees of fundus retinopathy,and serum SIRT4 level is significantly increased,and Keith-Wagener grading and SIRT4 are correlated with left ventricular remodeling and cardiac function grading.
基金项目
河北省医学科学研究课题计划项目(20191076)
河北省廊坊市科学技术研究与发展计划项目(2022013047)
NETL
NSTL
万方数据