首页|三种血清指标与冠心病心绞痛患者心功能和心肌损伤指标的关系

三种血清指标与冠心病心绞痛患者心功能和心肌损伤指标的关系

The relationship between three serum indicators and cardiac function and myocardial injury indicators in patients with CHD and angina pectoris

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目的 分析冠心病心绞痛患者血清GATA结合蛋白3(GATA-binding protein 3,GATA-3)、T细胞免疫球蛋白黏蛋白分子 3(T cell immunoglobulin domain and mucin domain protein-3,Tim-3)、视黄酸相关孤儿受体 γt(retin-oid-related orphan nuclear receptor gamma t,RORγt)水平与心功能、心肌损伤指标的相关性.方法 回顾性选取2020年12月至2023年12月哈尔滨市第一医院心内科收治的冠心病心绞痛患者120例作为观察组,根据心电图结果及冠状动脉造影分为稳定性心绞痛患者53例和不稳定性心绞痛患者67例.另外选择同期于本院进行健康体检的健康人群120例作为对照组.采用酶联免疫吸附测定法检测血清中GATA-3、Tim-3、RORγt水平,采用超声诊断仪检测左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end-systolic diameter,LVESD)、左心室短轴缩短率(left ventricular fractional shortening,LVFS),采用生化分析仪检测肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme-MB,CK-MB);采用电化学发光免疫分析仪检测肌钙蛋白Ⅰ(cardiac troponin Ⅰ,cTnⅠ)、心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP);采用 Pearson 相关性分析血清 GATA-3和Tim-3及RORγt水平与心功能和心肌损伤指标的相关性;采用ROC曲线分析血清GATA-3、Tim-3、RORγt水平对不稳定性心绞痛的预测价值.结果 观察组血清Tim-3、RORγt水平显著高于对照组,GATA-3水平显著低于对照组,差异有统计学意义[(397.14±78.42)ng/L vs(246.45±56.81)ng/L,P<0.01;(93.18±19.94)ng/L vs(35.72±7.79)ng/L,P<0.01;(38.21±9.45)ng/L vs(71.62±14.98)ng/L,P<0.01].观察组 LVEDD、LVESD 显著高于对照组,LVEF、LVFS显著低于对照组,差异有统计学意义(P<0.01).观察组cTnⅠ、CK、CK-MB、H-FABP显著高于对照组,差异有统计学意义(P<0.01).冠心病心绞痛患者血清GATA-3与LVEF、LVFS呈正相关,与LVEDD、LVESD、cTnⅠ、CK、CK-MB、H-FABP 呈负相关;Tim-3、RORγt 与 LVEF、LVFS 呈负相关,与 LVEDD、LVESD、cTnⅠ、CK、CK-MB、H-FABP 呈正相关(P<0.01).ROC 曲线分析显示,GATA-3、Tim-3、RORγt 单独及联合预测不稳定性心绞痛的AUC分别为0.859、0.827、0.780、0.921,联合预测的AUC显著优于单独预测(Z=1.993、3.021、4.532,P=0.036、0.007、0.001).结论 随着冠心病心绞痛患者疾病进展,血清Tim-3、RORyt水平升高,GATA-3水平降低,各指标与心功能和心肌损伤指标密切相关.
Objective To analyze the correlation of serum levels of GAT A-binding protein 3(GATA-3),T cell immunoglobulin domain and mucin domain protein-3(Tim-3)and retinoid-related orphan nuclear receptor gamma t(RORγt)with cardiac function and myocardial injury in-dicators in patients with coronary heart disease(CHD)and angina pectoris.Methods A retrospec-tive analysis was performed on 120 CHD patients with angina pectoris(observation group)in our hospital from December 2020 to December 2023.They were divided into stable angina subgroup(53 cases)and unstable angina subgroup(67 cases)according to the results of electrocardiography and coronary angiography.Another 120 healthy individuals taking physical examination in our hospital during the same period were subjected and served as the control group.ELISA was used to detect the serum levels of GATA-3,Tim-3 and RORγt.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and left ventricular short-axis shortening rate(FS)were measured by echocardio-graphy.Creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)were detected by biochemi-cal analyzer,and troponin Ⅰ(cTnⅠ)and heart fatty acid binding protein(H-FABP)were detected by electrochemiluminescence immunoassay.Pearson analysis was applied to analyze the correlation the correlation of serum levels of GATA-3,Tim-3 and RORγt with cardiac function and myocar-dial injury indicators.ROC curve was plotted to analyze the predictive value of the above three in-dicators for unstable angina.Results The serum levels of Tim-3 and ROR y t were significantly higher,and that of GATA-3 was obviously lower in the observation group than the control group(397.14±78.42 ng/L vs 246.45±56.81 ng/L,P<0.01;93.18±19.94 ng/L vs 35.72±7.79 ng/L,P<0.01;38.21±9.45 ng/L vs 71.62±14.98 ng/L,P<0.01).The LVEDD and LVESD values were notably higher,while the LVEF and LVFS values were remarkably lower in the observation group than the control group(P<0.01).The observation group has statistically higher cTnⅠ,CK,CK-MB,and H-FABP levels than the control group(P<0.01).In the CHD patients with angina pectoris,serum GATA-3 level was positively correlated with LVEF and LVFS,and negatively with LVEDD,LVESD,cTnⅠ,CK,CK-MB,and H-FABP;Tim-3 and RORγt were negatively corre-lated with LVEF and LVFS,and positively with LVEDD,LVESD,cTnⅠ,CK,CK-MB,and H-FABP(P<0.01).The AUC value of GATA-3,Tim-3,and RORγt alone and in combination in predicting unstable angina was 0.859,0.827,0.780,and 0.921,respectively,with that of combina-tion significantly higher than that of above indicators alone(Z=1.993,3.021,4.532,P=0.036,0.007,0.001).Conclusion As the disease progresses in CHD patients with angina pectoris,serum levels of Tim-3 and RORγt are increasing,while that of GATA-3 is decreasing,and all of them are closely associated with heart function and myocardial injury indicators.

coronary diseaseangina pectorishepatitis A virus cellular receptor 2nuclear receptor subfamily 1,group F,member 3GATA-binding protein 3

张春茹、吕健、周大亮、孙宪彬、郝丹

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150010 哈尔滨市第一医院心内科

冠心病 心绞痛 甲型肝炎病毒细胞受体2 核受体亚家族1,F组,成员3 GATA结合蛋白3

2025

中华老年心脑血管病杂志
中国人民解放军总医院

中华老年心脑血管病杂志

北大核心
影响因子:2.328
ISSN:1009-0126
年,卷(期):2025.27(1)