摘要
目的 研究糖尿病合并慢性心力衰竭(chronic heart failure,CHF)患者中α1-酸性糖蛋白(α1-acid glycoprotein,α1-AGP)、组织蛋白酶S(cathepsin,CatS)及丝氨酸蛋白酶抑制剂B1(serine protease inhibitor B1,SerpinB1)水平变化及临床意义.方法 选取河南科技大学第一附属医院2022年01月—2023年10月收治的80 例糖尿病患者,根据患者冠状动脉造影检查的结果将患者分为单纯糖尿病组和糖尿病合并CHF组,分别有41 例和39 例.另选取同期进行健康体检的健康志愿者40 名作为对照组.入院时收集所有受试者一般临床资料,包括年龄、性别、体重指数(BMI)、糖尿病病程、高血压病史、吸烟史、入院血压、空腹血糖、心功能参数水平(EF、EDV、ESV).收集受试者入院时尿液,测定尿液中α1-AGP水平.采取受试者清晨空腹静脉血,离心后取上清,采用酶联免疫吸附法测定血清中CatS及SerpinB1水平.比较三组受试者一般临床资料、心功能、α1-AGP、CatS及SerpinB1水平;采用Pearson分析α1-AGP、CatS及SerpinB1水平与心功能的相关性.结果 三组受试者年龄、性别、BMI、高血压病史、吸烟史差异无统计学意义(P＞0.05);单纯糖尿病组和糖尿病合并CHF组入院时舒张压、收缩压、空腹血糖、EDV和ESV水平均高于对照组,且糖尿病合并CHF组上述参数水平高于单纯糖尿病组(P＜0.05);单纯糖尿病组和糖尿病合并CHF组心功能参数EF水平均低于对照组,且糖尿病合并CHF组EF水平低于单纯糖尿病组(P＜0.05);糖尿病合并CHF组糖尿病病程长于单纯糖尿病组(P＜0.05).单纯糖尿病组和糖尿病合并CHF组尿液α1-AGP水平、血清CatS水平均高于对照组,SerpinB1水平低于对照组(P＜0.05),且糖尿病合并CHF组尿液α1-AGP水平、血清CatS水平更高,SerpinB1水平更低(P＜0.05).α1-AGP、CatS水平与心功能参数EDV和ESV水平均呈现明显的正相关(P＜0.05),与EF均呈现明显的负相关(P＜0.05).SerpinB1水平与心功能参数EDV和ESV水平均呈现明显的负相关(P＜0.05),与EF均呈现明显的正相关(P＜0.05).结论 糖尿病合并CHF患者中α1-AGP、CatS均呈现明显的高表达水平,SerpinB1呈现低表达水平,且与心功能呈现相关性.
Abstract
Objective To study the changes and clinical significance of α1-acid glycoprotein(α1-AGP),cathepsin S(CatS)and serine protease inhibitor B1(SerpinB1)in patients with diabetes complicated with chronic heart failure(CHF).Methods 80 diabetic patients admitted to First Affiliated Hospital of Henan University of Science and Technology from January 2022 to October 2023 were divided into simple diabetes group and diabetes combined with CHF group according to the results of coronary angiography,with 41 cases and 39 cases respectively.In addition,40 healthy volunteers who underwent physical examination during the same period were selected as the control group.General clinical data of all subjects were collected at the time of admission,including age,sex,body mass index(BMI),course of diabetes,history of hypertension,smoking history,admission blood pressure,fasting blood glucose and cardiac function parameters(EF,EDV,ESV).Urine was collected when the subjects were admitted to hospital,and the level of α1-AGP in urine was determined.The fasting venous blood of the subjects in the morning was taken,and the supernatant was taken after centrifugation.The levels of CatS and SerpinB1 in serum were determined by enzyme-linked immunosorbent assay.The general clinical data,cardiac function,α1-AGP,CatS and SerpinB1 levels of the three groups were compared.Pearson was used to analyze the correlation between α1-AGP,CatS and SerpinB1 levels and cardiac function.Results There were no significant differences in age,gender,BMI,history of hypertension and smoking history among the three groups(P＞0.05).The levels of diastolic blood pressure,systolic blood pressure,fasting blood glucose,EDV and ESV in simple diabetes group and diabetes combined with CHF group were higher than those in control group,and the above parameters in diabetes combined with CHF group were higher than those in simple diabetes group(P＜0.05).The level of cardiac function parameter EF in both simple diabetes group and diabetes combined with CHF group was lower than that in control group,and the level of EF in diabetes combined with CHF group was lower than that in simple diabetes group(P＜0.05).The duration of diabetes in diabetes combined with CHF group was longer than that in simple diabetes group(P＜0.05).The levels of urine α1-AGP and serum CatS in simple diabetes group and diabetes combined with CHF group were higher than those in the control group,while the level of SerpinB1 was lower than that in the control group(P＜0.05).The levels of urine α1-AGP and serum CatS were higher and SerpinB1 was lower in diabetes combined with CHF group(P＜0.05).The levels of α1-AGP and CatS were positively correlated with the levels of cardiac function parameters EDV and ESV(P＜0.05)and negatively correlated with EF(P＜0.05).SerpinB1 level was negatively correlated with cardiac function parameters EDV and ESV levels(P＜0.05)and positively correlated with EF(P＜0.05).Conclusion The levels of α1-AGP and CatS in patients with diabetes complicated with CHF are obviously high,while SerpinB1 is low,which is correlated with cardiac function.
维普
万方数据