血清可溶性信号素4D、生长分化因子-15、趋化素与原发性高血压患者左心室重构的相关性

Correlation between serum soluble semaphorin 4D, growth differentiation factor-15, chemerin and left ventricular remodeling in patients with hypertension

    摘要
  • 摘要: 目的探讨血清可溶性信号素4D（sSema4D）、生长分化因子-15（GDF-15）、趋化素与原发性高血压（EH）患者左心室重构的相关性。方法 2016年1月至2018年1月期间,选取心内科就诊的236例EH患者作为研究对象,根据左心室质量指数（LVMI）将患者分为高血压伴左心室肥厚组（EH+LVH组,n=98）和高血压不伴左心室肥厚组（EH+NLVH组,n=138）。选取同期体检的健康人群100人为对照组。比较各组间基础资料、血清sSema4D、GDF-15、趋化素水平,并进行Pearson相关分析与Logistic多元回归分析。结果 EH+LVH组血压（161.4±10.2）/（99.1±6.3）mm Hg与EH+NLVH组血压（154.5±9.8）/（93.5±7.1）mm Hg高于对照组（112.1±9.1）/（79.0±8.1）mm Hg;均P<0.05。EH+LVH组血清sSema4D（1 268.9±153.7）比（913.6±136.9）比（402.6±120.6）ng/L、GDF-15（1 215.5±369.2）比（1 063.7±341.3）比（321.6±95.8）ng/L、趋化素水平（701.4±134.7）比（491.3±117.7）比（314.6±102.3）μg/L、左心室舒张末期内径LVEDd:（55.2±6.4）比（52.4±5.9）比（50.4±5.6）mm、LVMI（128.4±10.2）比（95.3±8.7）比（71.3±7.6）g/m2高于EH+NLVH组和对照组（均P<0.05）。Pearson相关性分析显示,sSema4D、GDF-15、趋化素与EH患者LVEDd、LVMI呈正相关（r=0.561、0.701、0.602;0.557、0.734、0.715;均P<0.05）。Logistic多元逐步回归分析显示,sSema4D、GDF-15、趋化素是EH患者发生心室重构的影响因素OR（95%CI）:1.099（1.014～1.190）,1.059（1.016～1.103）,1.338（1.070～1.673）;均P<0.05。结论 sSema4D、GDF-15、趋化素可能参与了EH患者的左心室重构病理过程。

     

    Abstract: Objective To investigate the relationship between serum soluble semaphorin 4 D（sSema4 D）, growth differentiation factor-15（GDF-15）, Chemerin and left ventricular remodeling in essential hypertensive（EH） patients. Methods From January 2016 to January 2018, 236 EH patients who visited the department of cardiology were selected as subjects. According to the left ventricular mass index（LVMI）, the patients were divided into two groups: hypertension with left ventricular hypertrophy（EH+LVH） group（n=98） and hypertension without left ventricular hypertrophy group（EH+NLVH group, n=138）. A total of 100 healthy people who visited the hospital for physical examination at the same time were selected as the control group. The general information, the level of serum sSema4 D, GDF-15 and Chemerin among the three groups were compared, and Pearson correlation analysis and Logistic multiple regression analysis were used to analyze the correlation between sSema4 D, GDF-15, Chemerin and left ventricular remodeling. Results The systolic and diastolic blood pressure in EH+LVH group（161.4±10.2）/（99.1±6.3） mm Hg and EH+NLVH group（154.5±9.8）/（93.5±7.1）mm Hg were significantly higher than that in control group（112.1±9.1）/（79.0±8.1）mm Hg, P＜0.05. The levels of serum sSema4 D （1 268.9±153.7） vs（913.6±136.9） vs（402.6±120.6）ng/L, GDF-15 （1 215.5±369.2） vs（1 063.7±341.3） vs（321.6±95.8） ng/L, Chemerin （701.4±134.7） vs（491.3±117.7） vs（314.6±102.3） g/L, left ventricular end-diastolic dimension LVEDd:（55.2±6.4） vs（52.4±5.9） vs（50.4±5.6） mm, and LVMI （128.4±10.2） vs（95.3±8.7） vs（71.3±7.6）g/m~2 in EH+LVH group were significantly higher than those in EH+NLVH group and control group（P＜0.05）. Pearson correlation analysis showed that there were positive correlation between sSema4 D, GDF-15, Chemerin and LVDd, LVMI in EH patients（r=0.561, 0.701, 0.602; 0.557, 0.734, 0.715, P＜0.05）. Multiple stepwise Logistic regression analysis showed that sSema4 D, GDF-15, Chemerin were risk factors for ventricular remodeling in patients with EH OR（95% CI）:1.099（1.014-1.190）,1.059（1.016-1.103）,1.338（1.070-1.673）. Conclusion sSema4 D, GDF-15, Chemerin may be involved in the pathological process of left ventricular remodeling in patients with EH.

     

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