血清TGF-β1、sST2水平与胸主动脉瘤病变长度和病变程度的关系

目的探讨血清转化生长因子β1(TGF-β1)、可溶性生长刺激表达因子2蛋白(sST2)水平与胸主动脉瘤(TAA)病变长度和病变程度的关系,分析血清TGF-β1、sST2水平诊断胸主动脉瘤的价值。方法选择2018年7月—2020年12月四川大学华西广安医院收治的72例TAA患者(TAA组)和77例健康志愿者(对照组),检测血清TGF-β1、sST2、炎症因子以及纤维化指标水平,超声心动图测量胸主动脉瘤病变长度和病变程度。Pearson或Spearman相关分析TGF-β1、sST2与胸主动脉瘤病变长度和病变程度、炎症因子以及纤维化指标的相关性。Logistic回归分析胸主动脉瘤的危险因素,受试者工作特征(ROC)曲线分析TGF-β1、sST2诊断胸主动脉瘤的价值。结果TAA组血清TGF-β1、sST2水平高于对照组(t=18.480、27.534,P<0.05)。血清TGF-β1、sST2水平与胸主动脉瘤病变长度和病变程度、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、白细胞介素33(IL-33)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层黏连蛋白(LN)均呈正相关(r/r_s=0.751~0.921,P<0.05)。高水平IL-33OR(95%CI)=1.250(1.062~1.471)]、PCⅢOR(95%CI)=1.390(1.131~1.707)]、Ⅳ-COR(95%CI)=1.141(1.005~1.296)]、TGF-β1OR(95%CI)=2.447(1.370~4.372)]、sST2OR(95%CI)=1.749(1.327~2.306)]是胸主动脉瘤发病的危险因素(P<0.05)。TGF-β1与sST2联合诊断胸主动脉瘤的ROC曲线下面积(AUC)为0.826,高于单独TGF-β1或sST2诊断(P<0.05)。结论血清TGF-β1、sST2水平增高与胸主动脉瘤的发生以及胸主动脉瘤病变长度和病变程度均有关,可作为胸主动脉瘤病情评估的潜在指标。

Relationship between serum TGF-β1,sST2 levels and lesion length and lesion degree of thoracic aortic aneurysm

Aim To investigate the relationship between serum transforming growth factor β1(TGF-β1),soluble suppression of tumorigenicity-2(sST2)and the length and severity of thoracic aortic aneurysm(TAA),and to analyze the diagnostic value of serum TGF-β1 and sST2 in the diagnosis of TAA.Methods A total of 72 TAA patients(TAA group)admitted to West China Guang an Affiliated Hospital of Sichuan University from July 2018 to December 2020 and 77 healthy volunteers(control group)were selected.Serum levels of TGF-β1,sST2,inflammatory factors and fibrosis indexes were detected.The lesion length and lesion degree of TAA were measured by echocardiography.Pearson or Spearman correlation coefficient was used to describe the correlation between TGF-β1,sST2 and lesion length,lesion degree,inflammatory factors,fibrosis indexes.Logistic regression was used to analyze the risk factors of TAA and the value of TGF-β1 and sST2 in the diagnosis of TAA was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum TGF-β1 and sST2 were higher in TAA group than those in control group(t=18.480,27.534,P<0.05).Serum TGF-β1 and sST2 levels were positively correlated with the length of thoracic aortic lesion,the degree of thoracic aortic lesion,interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-33(IL-33),hyaluronic acid(HA),type Ⅲ procollagen(PC Ⅲ),type Ⅳ collagen,(Ⅳ-C),and laminin(LN)(r/r_s=0.751~0.921,P<0.05).High levels of IL-33(OR(95%CI)=1.250(1.062~1.471)),PC Ⅲ(OR(95%CI)=1.390(1.131~1.707)),Ⅳ-C(OR(95%CI)=1.141(1.005~1.296)),TGF-β1(OR(95%CI)=2.447(1.370~4.372))and sST2(OR(95%CI)=1.749(1.327~2.306))were risk factors for TAA(P<0.05).The area under curve(AUC)of combined TGF-β1 and sST2 for diagnosis of TAA was 0.826,which was higher than that of TGF-β1 and sST2 alone(P<0.05).Conclusion The increase of serum TGF-β1 and sST2 levels is associated with the occurrence of TAA,the length and degree of TAA lesion,and can be used as a potential indicator for the evaluation of TAA disease.