高血压左心室肥厚患者血浆中自噬相关蛋白9a的水平及其临床意义

目的：探讨高血压左心室肥厚（LVH）患者血浆中自噬相关蛋白9a （ATG9a）水平与舒张期末室间隔厚度（IVSd）和舒张期末左心室后壁厚度（LVPWd）的关系，进一步评估其对高血压患者LVH的临床预测作用。方法：高血压住院患者128例，根据心脏彩色超声结果分为LVH组66例和非LVH组62例。采用酶联免疫吸附测定（ELISA）法检测患者血浆中ATG9a水平，分析高血压LVH患者血浆ATG9a水平与IVSd和LVPWd的相关性，并计算受试者工作特征（ROC）曲线下面积（AUC）。结果：高血压LVH组患者血浆中ATG9a水平高于非LVH组（P<0.05）；高血压LVH患者血浆中ATG9a平均水平与患者IVSd和LVPWd均呈正相关关系（r=0.774，P<0.01；r=0.685，P<0.01）；测定高血压LVH患者血浆ATG9a水平的AUC为0.976（95％CI：0.923~0.996），预测高血压LVH的最佳临界值为1.69 μg·L^-1，其敏感度和特异度分别为96.8%和90.6%。结论：血浆ATG9a可能作为自噬诱导因子参与心肌肥厚的发病。血浆ATG9a水平与高血压LVH患者室壁厚度呈正相关关系，血浆ATG9a水平可预测高血压患者LVH。

Level of autophagy-related protein-9a in plasma of hypertension patients with left ventricular hypertrophy and its clinical significance

Objective:To explore the relationships between the levels of autophagy-related protein 9a (ATG9a) in the plasma and the end-diastolic interventricular septum dimension(IVSd) and left ventricular posterior wall dimension (LVPWd) in the hypertension patients with left ventricular hypertrophy (LVH),and to further evaluate its effect in clinical prediction for the hypertension patients with LVH. Methods: One hundred and twenty-eight hypertension patients in hospital were enrolled.According to the results of cardiac echocardiography,all enrolled patients were divided into LVH group (n=66) and non-LVH group (n=62).The levels of plasma ATG9a in the patients ware detected by enzyme linked immunosorbent assay (ELISA).The levels of plasma ATG9a of the patients in LVH group and non-LVH group were compared.The correlations between the levels of plasma ATG9a and IVSd or LVPWd in the hypertension patients with LVH were further analyzed.And the area under receiver operating characteristic curve (AUC) of plasma ATG9a level was calculated. Results:The plasma ATG9a level of the hypertension patients in LVH group was higher than that in non-LVH group (P<0.05).The plasma ATG9a level in the patients with LVH showed significantly positive correlations with IVSd and LVPWd(r=0.774,r=0.685,P<0.01). The AUC for plasma ATG9a level was 0.976(95%CI:0.923-0.996).The optimal cut-off value of plasma ATG9a level for ROC curve was 1.69 μg·L^-1,the sensitivity and specificity were 96.8% and 90.6%,respectively. Conclusion:The plasma ATG9a may play an important role in the pathogenesis of myocardial hypertrophy as autophagy-induced factor. The level of plasma ATG9a has positive correlation with IVSd and LVPWd in the hypertension patients with LVH. The level of plasma ATG9a may predict the LVH in the hypertension patients.