热休克蛋白27诊断射血分数保留心力衰竭的价值

目的 目前对射血分数保留心力衰竭（HFPEF）的诊断标志物有限，探讨热休克蛋白27（Hsp27）诊断HFPEF的价值。方法 纳入77例HFPEF患者和48例健康对照组患者，比较两组患者一般资料，实验室检查。比较两组患者Hsp27和NT-Pro-BNP以及心功能。采用ROC曲线分析Hsp27和NT-Pro-BNP诊断HFPEF的特异性和敏感度。分析Hsp27和NT-Pro-BNP与心脏舒张功能的相关性。结果 两组患者间性别、年龄、体重指数比较差异均无统计学意义（P>0.05）。两组患者合并脑卒中的比例比较差异无统计学意义（P>0.05），HFPEF患者合并糖尿病、高血压、心房颤动多于对照组（P<0.05）。HFPEF组服用ACEI/ARB、β受体阻滞剂、呋塞米、地高辛和他汀类药物的患者较对照组明显增多（P<0.05）。HFPEF患者Hsp27和NT-pro-BNP的水平明显高于对照组（P<0.05）。两组患者心脏收缩功能比较差异无统计学意义（P>0.05），而HFPEF患者心脏舒张功能明显低于对照组（P<0.05）。ROC曲线结果显示，Hsp27的ROC曲线下面积高于NT-pro-BNP，且其特异性强于NT-pro-BNP。Pearson相关分析结果显示，Hsp27和NT-pro-BNP均与心脏舒张功能明显相关（P<0.05）。结论 Hsp27可以作为辅助诊断HFPEF的新标志物。

Heat Shock Protein 27 as Novel Candidate Biomarkers of Chronic Heart Failure with Preserved Ejection Fraction

Objective The current clinical biomarkers of chronic heart failure have limitations. Heat shock protein 27 (Hsp27) were tested for their potential as novel biomarkers for diagnosing chronic heart failure with preserved ejection fraction (HFPEF). Methods We compared the circulating levels of Hsp27 in patients with HFPEF (n=77) and control (n=48). We assessed whether these candidates were superior to NT-pro-BNP as diagnostic tools. Results There were no differences between the two groups in gender, age, body mass index (P>0.05). There is no difference between the two groups of patients complicated with stroke (P>0.05). The complication with diabetes, hypertension, and AF in patients with HFPEF is more than in the control group (P<0.05). Patients in group HFPEF took ACEI/ARB, beta blockers, furosemide, digoxin and statins were significantly increased compared with the control group (P<0.05). Hsp27 and NT-pro-BNP in HFPEF patients was significantly higher than control group (P<0.05). There were no differences between the two groups of patients in cardiac systolic function (P>0.05).Bat diastolic function in patients with HFPEF was significantly lower than the control group (P<0.05). The ROC curve showed that the area under the ROC curve of Hsp27 was higher than that of NT-pro-BNP, and its specificity was stronger than that of NT-pro-BNP. Pearson correlation analysis showed that both Hsp27 and NT-pro-BNP were significantly related to cardiac diastolic function (P<0.05). Conclusion Hsp27 can be used as a new marker for the diagnosis of HFPEF.