慢性心力衰竭患者血清Lp-PLA2、sSema4D的表达及临床意义

目的分析慢性心力衰竭(CHF)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、可溶性重组蛋白质类信号4D(sSema4D)的表达及临床意义。方法选取2018年4月-2019年4月黄冈市中心医院收治的CHF患者112例作为研究组,另选取体检健康者60例作为健康对照组。比较2组研究对象及不同NYHA分级CHF患者血清LpPLA2、sSema4D水平及超声心动图指标水平,分析CHF患者血清Lp-PLA2、sSema4D水平与超声心动图指标的相关性。结果研究组血清Lp-PLA2、sSema4D水平高于健康对照组(t=43.670、21.005,P均=0.000),左心房内径(LAD)、右心室内径(RVD)、左心舒张末期内径(LVEDD)大于健康对照组(t=16.903、11.183、13.885,P均=0.000);左心室射血分数(LVEF)及左心室短轴缩短率(LVFS)低于健康对照组(t=27.147、30.592,P均=0.000)。随着NYHA分级的升高,CHF患者血清Lp-PLA2、sSema4D水平及LAD、RVD、LVEDD明显增加(F=49.842、38.674、35.821、26.382、41.377,P均=0.000),而LVEF、LVFS明显下降(F=61.760、52.374,P均=0.000)。Pearson相关分析显示,CHF患者血清Lp-PLA2、s Sema4D水平与LAD、RVD、LVEDD均呈正相关(Lp-PLA2:r=0.562、0.514、0.613,P均=0.000;sSema4D:r=0.642、0.576、0.625,P均=0.000),而与LVEF、LVFS呈负相关(Lp-PLA2:r=-0.511、-0.472,P均=0.000;sSema4D:r=-0.507、-0.458,P均=0.000)。结论随着CHF患者心功能的恶化血清Lp-PLA2、sSema4D水平升高,并与超声心动图指标存在一定的相关性,提示Lp-PLA2和sSema4D可能通过影响心室重构参与到CHF的发生、发展。

The expression and clinical significance of serum Lp-PLA 2 and sSema4D in patients with chronic heart failure

Objective To analyze the expression and clinical significance of serum lipoprotein associated phospholipase A2(Lp-PLA2) and soluble recombinant protein signal 4 D(sSema4 D) in patients with chronic heart failure(CHF).Methods One hundred and twelve CHF patients admitted to Huanggang Central Hospital from April 2018 to April 2019 were selected as the study group.Another 60 healthy people were selected as the control group.The level of Lp-PLA2 and sSema4 D in serum and the level of echocardiographic indexes in CHF patients with different NYHA grades were compared.Results The levels of serum Lp-PLA2 and sSema4 D in the study group were higher than those in the healthy control group(t=43.670,21.005,P=0.000).The left atrial diameter(LAD),right ventricle diameter(RVD),and left end diastolic diameter(LVEDD) were greater than Healthy control group(t=16.903,11.183,13.885,P=0.000).The left ventricular ejection fraction(LVEF) and left ventricular short-axis shortening rate(LVFS) were lower than those in the healthy control group(t=27.147,30.592,P=0.000).With the increase of NYHA classification,serum levels of Lp-PLA2,sSema4 D,and LAD,RVD,and LVEDD in CHF patients increased significantly.(F=49.842,38.674,35.821,26.382,41.377,P=0.000),while LVEF and LVFS decreased significantly(F=61.760,52.374,P=0.000).Pearson correlation analysis showed that serum levels of Lp-PLA2 and sSema4 D in patients with CHF were positively correlated with LAD,RVD,and LVEDD(Lp-PLA2:r=0.562,0.514,0.613,P=0.000;sSema4 D:r=0.642,0.576,0.625.P=0.000),but negatively correla ted with LVEF and LVFS(Lp-PLA2:r=-0.511,-0.472,P=0.000;sSema4 D:r=-0.507,-0.458,P=0.000).Conclusion With the deterioration of heart function in patients with CHF,the level of serum Lp-PLA2 and sSema4 D in creased,and there was a certain correlation with echocardiographic indexes,suggesting that Lp-PLA2 and sSema4 D may par ticipate in the occurrence and development of CHF by affecting ventricular remodeling.