摘要
目的探究原发性高血压患者血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、脂联素(APN)、可溶性ST2(sST2)、C型利钠肽(CNP)水平与左心室肥厚的相关性。方法将2022年1月至2024年10月西安市第九医院收治的102例原发性高血压患者,按照左心室质量指数(LVMI)将原发性高血压伴左心室肥厚患者[LVMI为≥95 g/m^(2)(女)、≥115 g/m^(2)(男)]分为观察组54例,将原发性高血压不伴左心室肥厚患者[LVMI为<95 g/m^(2)(女)、<115 g/m^(2)(男)]分为对照组48例,对比两组血清NGAL、APN、sST2、CNP水平及心功能参数[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、心率(HR)、舒张压、收缩压],分析血清NGAL、APN、sST2、CNP水平与LVMI、心功能的关系及上述血清学参数预测原发性高血压左室肥厚的价值。结果观察组患者血清NGAL、sST2、CNP水平及LVMI较对照组高,APN较对照组低(P<0.05);观察组LVEDD、LVESD、HR、收缩压、舒张压均较对照组高,LVEF较对照组低(P<0.05);原发性高血压伴左心室肥厚患者血清APN与LVMI呈负相关(P<0.05),血清NGAL、sST2、CNP与其LVEF存在负相关,与其LVMI、LVEDD、LVESD存在正相关(P<0.05),血清NGAL预测原发性高血压左心室肥厚效能最高,约登指数最大时,对应临界值为15.32 ng/mL,曲线下面积为0.826,敏感度为0.91,特异性为0.71;NGAL≥15.32 ng/mL、APN≤10.52 mg/L、sST2≥24.49 ng/L、CNP≥21.99 ng/L是原发性高血压患者发生左心室肥厚的危险因素(P<0.05)。结论原发性高血压伴左心室肥厚患者血清NGAL、sST2、CNP水平偏高,APN水平偏低,且与心功能异常密切相关,可作为预测左心室肥厚的指标。
Objective To explore the correlation among neutrophil gelatinase-associated lipocalin(NGAL),adiponectin(APN),soluble suppression of tumorigenicity 2(sST2),C-type natriuretic peptide(CNP)and left ventricular hypertrophy(LVH)in patients with essential hypertension(EH).Methods EH patients(n=102)admitted in the Nineth Hospital of Xi`an City from Jan.2022 to Oct.2024 were divided,according to left ventricular mass index(LVMI),into observation group[n=54,including EH patients complicated by LVH,LVMI≥95 g/m^(2)(female),LVMI≥115 g/m^(2)(male)],and control group[n=48,including EH patients without LVH,LVMI<95 g/m^(2)(female),LVMI<115 g/m^(2)(male)].The levels of serum NGAL,APN,sST2 and CNP,as well as heart function parameters[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),heart rate(HR),diastolic blood pressure(DBP),systolic blood pressure(SBP)]were compared between 2 groups.The relationship among the levels of serum NGAL,APN,sST2 and CNP,LVMI and heart function was analyzed,and the value of aforementioned serological parameters was evaluated in predicting LVH in EH.Results The levels of serum NGAL,sST2 and CNP and LVMI were higher,and APN was lower in observation group than those in control group (P<0.05). LVEDD, LVESD, HR, SBP and DBP were higher, and LVEF was lower in observation group than those in control group (P<0.05). In EH patients complicated by LVH, APN was negatively correlated to LVMI (P<0.05), and serum NGAL, sST2 and CNP were negatively correlated to LVEF, and positively correlated to LVMI, LVEDD and LVESD (P<0.05). Serum NGAL has the highest efficacy in predicting LVH in EH. When Youden index reached its maximum, the corresponding cut-off value was 15.32 ng/mL, the area under the curve (AUC) was 0.826, sensitivity was 0.91, and specificity was 0.71. NGAL≥15.32 ng/mL, APN≤10.52 mg/L, sST2≥24.49 ng/L and CNP≥21.99 ng/L were risk factors for LVH occurrence in EH patients (P<0.05). Conclusion The levels of serum NGAL, sST2 and CNP are higher and APN level is lower, and are closely correlated to abnormal heart function, and can be used as indicators to predict LVH in EH patient complicated by LVH.
作者
马宏恩
王鑫
季朝红
魏文扬
周娜
MA Hong'en;WANG Xin;JI Zhaohong;WEI Wenyang;ZHOU Na(Department of Cardiovascular Medicine,Nineth Hospital of Xi`an City,Xi'an 710054,China)
出处
《中国循证心血管医学杂志》
2025年第11期1322-1327,共6页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
陕西省自然科学基础研究计划项目(2022JM-580)
西安市科技计划项目(23YXYJ0049)。
关键词
原发性高血压
中性粒细胞明胶酶相关脂质运载蛋白
脂联素
可溶性ST2
C型利钠肽
左心室肥厚
essential hypertension
neutrophil gelatinase-associated lipocalin
adiponectin
soluble suppression of tumorigenicity 2
C-type natriuretic peptide
left ventricular hypertrophy
