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瓣膜性心脏病患者血清热休克蛋白70、骨桥蛋白、基质金属蛋白酶-9表达水平及其与心功能的相关性

Expression levels of serum heat shock protein 70, osteopontin and matrix metalloproteinase-9 in patients with valvular heart disease and their correlations with cardiac function

    摘要
  • 摘要:
    目的 探讨瓣膜性心脏病患者血清热休克蛋白70(HSP70)、骨桥蛋白(OPN)、基质金属蛋白酶-9(MMP-9)表达水平及其与心功能的相关性。
    方法 选取瓣膜性心脏病患者168例作为研究组，另选取同期体检的健康者100例作为健康组。检测并比较2组血清HSP70、OPN、MMP-9的表达水平。将168例患者根据心功能分级分为Ⅱ级组(n=68)、Ⅲ级组(n=57)和Ⅳ级组(n=43)，比较不同心功能分级的瓣膜性心脏病患者的血清HSP70、OPN、MMP-9表达水平。分析血清HSP70、OPN、MMP-9表达水平与左心室射血分数(LVEF)的相关性。筛选瓣膜性心脏病患者心功能分级的影响因素。采用受试者工作特征(ROC)曲线分析血清HSP70、OPN、MMP-9对瓣膜性心脏病患者心功能分级的诊断效能。
    结果 研究组血清HSP70、OPN、MMP-9表达水平高于健康组，差异有统计学意义(P < 0.05)。多瓣膜病变患者血清HSP70、OPN、MMP-9表达水平高于单瓣膜病变患者，差异有统计学意义(P < 0.05)。Ⅲ级组、Ⅳ级组患者的血清HSP70、OPN、MMP-9表达水平高于Ⅱ级组，差异有统计学意义(P < 0.05); Ⅳ级组血清HSP70、OPN、MMP-9表达水平高于Ⅲ级组，差异有统计学意义(P < 0.05)。年龄、合并糖尿病、疾病分类、LVEF、HSP70、OPN、MMP-9是瓣膜性心脏病患者心功能分级的影响因素(P < 0.05)。血清HSP70、OPN、MMP-9与瓣膜性心脏病患者心功能指标LVEF呈显著负相关(r=-0.611、-0.584、-0.624, P < 0.001)。血清HSP70、OPN、MMP-9联合诊断瓣膜性心脏病患者心功能分级的效能优于其单独诊断(P < 0.05)。
    结论 瓣膜性心脏病患者的血清HSP70、OPN和MMP-9水平呈高表达，并随着心功能分级的增加而进一步升高。

     

    Abstract:
    Objective To investigate the expression levels of heat shock protein 70 (HSP70), osteopontin (OPN) and matrix metalloproteinase-9 (MMP-9) in patients with valvular heart disease and their correlations with cardiac function.
    Methods A total of 168 patients with valvular heart disease were selected as study group, while 100 healthy individuals who underwent physical examination during the same period served as healthy control group. Serum levels of HSP70, OPN and MMP-9 were measured and compared between the two groups. The 168 patients were further divided into grade Ⅱ group (n=68), grade Ⅲ group (n=57) and grade Ⅳ group (n=43) based on the classification of cardiac function in patients with valvular heart disease. Serum levels of HSP70, OPN and MMP-9 were compared among different cardiac function grades. The correlations of serum levels of HSP70, OPN and MMP-9 with left ventricular ejection fraction (LVEF) were analyzed. Factors influencing cardiac function grading in patients with valvular heart disease were screened. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of serum HSP70, OPN and MMP-9 for cardiac function grading in patients with valvular heart disease.
    Results Serum levels of HSP70, OPN and MMP-9 in the study group were significantly higher than those in the healthy control group (P < 0.05). Patients with multiple valve lesions had significantly higher serum levels of HSP70, OPN and MMP-9 compared to those with single valve lesions (P < 0.05). Serum levels of HSP70, OPN and MMP-9 in grade Ⅲ group and grade Ⅳ group were significantly higher than those in the grade Ⅱ group (P < 0.05); serum levels of HSP70, OPN and MMP-9 in the grade Ⅳ group were significantly higher than those in the grade Ⅲ group (P < 0.05). Age, co-morbid diabetes, disease classification, LVEF, HSP70, OPN and MMP-9 were identified as factors influencing cardiac function grading in patients with valvular heart disease (P < 0.05). Serum levels of HSP70, OPN and MMP-9 showed significant negative correlations with LVEF in patients with valvular heart disease (r=-0.611, -0.584, -0.624, P < 0.001). Combined diagnosis using serum HSP70, OPN and MMP-9 demonstrated superior diagnostic performance for cardiac function grading in patients with valvular heart disease compared to individual markers (P < 0.05).
    Conclusion Serum levels of HSP70, OPN and MMP-9 are elevated in patients with valvular heart disease and increase with the progression of cardiac function grading.

     

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