心型脂肪酸结合蛋白与肺动脉高压的相关性临床研究
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摘要
目的研究心型脂肪酸结合蛋白(H-FABP)与肺动脉高压(PAH)的临床相关性。方法选取2016年4月~12月我院收治的PAH患者90例(不需要区分肺动脉高压的类型),按照肺动脉压力高低分为轻、中、重三个亚组;按照病因分为慢性血栓性PAH,低氧血症性PAH、左心疾病相关性PAH。对照组为同期健康体检者80例。采用双抗夹心ELISA法测定患者血清H-FABP含量,同时检测肌酸激酶同工酶(CKMB),肌钙蛋白I(c TNI),NT-pro BNP水平,并做统计学分析。随访时间为1年,统计全因死亡率。结果肺动脉高压各组患者H-FABP水平明显高于对照组,差异有统计学意义(P<0.05),CKMB与c TNI组间比较,差异无统计学意义(P>0.05);不同病因的肺动脉高压患者H-FABP水平的比较,差异无统计学意义(P>0.05);随访时间为1年,统计死亡发生率,发现H-FABP与死亡率具有一定相关性(P<0.01)。结果 H-FABP与全因死亡率相关(P<0.01)。结论 PAH患者H-FABP水平较高,H-FABP水平可以评估肺动脉压力的危险程度,H-FABP为全因死亡率的独立危险因素。
Objective To study the clinical correlation between heart fatty acid binding protein(H-FABP)and pulmonary arterial hypertension(PAH).Methods Ninety patients with PAH admitted to our hospital from April 2016 to April 2017(without distinguishing the type of pulmonary hypertension) were selected and divided into experimental group and control group. the experimental group was divided into light,medium and heavy subgroups according to the pulmonary artery pressure.Chronic thrombotic PAH,hypoxemia PAH and left heart disease-related PAH were classified according to etiology.The control group was 80 cases of health examination in the same period. H-fabp content in serum of patients was determined by double antibody sandwich ELISA,and creatine kinase isoenzyme(ckmb),troponin I(ctni),nt-pro BNP levels were detected and analyzed statistically.The follow-up time was 18 months and all-cause mortality was counted.Results The levels of H-FABP in PAH patients were significantly higher than those in healthy controls(P<0.05).CKMB and c TNI showed no significant difference after inter-group comparison(P>0.05).There was no significant difference in H-FABP levels among PAH patients in different etiologies(P>0.05).After 1 year follow up visits,H-FABP was associated with all-cause mortality(P<0.01).Conclusion PAH patients have high H-FABP level which can be used to evaluate the risk of pulmonary arterial pressure.H-FABP is an independent risk factor for all-cause mortality.
Objective To study the clinical correlation between heart fatty acid binding protein(H-FABP)and pulmonary arterial hypertension(PAH).Methods Ninety patients with PAH admitted to our hospital from April 2016 to April 2017(without distinguishing the type of pulmonary hypertension) were selected and divided into experimental group and control group. the experimental group was divided into light,medium and heavy subgroups according to the pulmonary artery pressure.Chronic thrombotic PAH,hypoxemia PAH and left heart disease-related PAH were classified according to etiology.The control group was 80 cases of health examination in the same period. H-fabp content in serum of patients was determined by double antibody sandwich ELISA,and creatine kinase isoenzyme(ckmb),troponin I(ctni),nt-pro BNP levels were detected and analyzed statistically.The follow-up time was 18 months and all-cause mortality was counted.Results The levels of H-FABP in PAH patients were significantly higher than those in healthy controls(P<0.05).CKMB and c TNI showed no significant difference after inter-group comparison(P>0.05).There was no significant difference in H-FABP levels among PAH patients in different etiologies(P>0.05).After 1 year follow up visits,H-FABP was associated with all-cause mortality(P<0.01).Conclusion PAH patients have high H-FABP level which can be used to evaluate the risk of pulmonary arterial pressure.H-FABP is an independent risk factor for all-cause mortality.
引文
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[13]Lankeit C,Dellas A,Panzenbock A,et al.Heart-type fatty acid-binding protein for risk assessment of chornic throm boembolic pulmonary hypertension[J].Eur Respir J,2008,31(5):1024-1029.
[14]Naito A,Tanabe N,Jujo T,et al.Pentraxin3 in chronic thromboembolic pulmonary hypertension:a new biomarker for screening from remitted pulmonary thromboembolism[J].PLo S One,2014;9(11):e113086.
[15]王吉耀,廖二元.内科学(八年制)[M].第3版,北京:人民卫生出版社,2015,124-125.
[2]Nursalim A,Suryaatmadja M,Panggabean M.Potential clinical application of novel cardiac biomarkers for acute myocardial infarction[J].Acta Med Indones,2013,45(3):240-250.
[3]Rebecca L,Smathers,Dennis R Petersen.The human fatty acid-binding protein family:Evolutionary divergences and functions[J].Hum Genomics.2011,5(3):170-191.
[4]Ma X,Ren X,Han P,et al.Si RNA against Fabp5 induces3T3-L1 cells apoptosis during adipocytic induction[J].Mol Biol Rep,2010,37(8):4003-4011.
[5]王勇,柳志红.心型脂肪酸结合蛋白在心肺疾病中的研究进展[J].心血管病学进展,2010,31(3):367-369.
[6]Schermuly PT,Ghofrani HA,Wilkins MR,et al.Mechanisms of disease:pulmonary arterial hypertension[J].Nat Rec Cardiol.2011,8(8):443-455.
[7]李建生,王明航,余学庆.评估慢性阻塞性肺疾病病情和疗效的指标研究[J].中国老年学杂志,2010,30(1):118-121.
[8]张欢,华毛,冯喜英,等.脑钠肽、低氧诱导因子-1α、心肌型脂肪酸结合蛋白在高原肺动脉高压中的研究进展[J].中华肺部疾病杂志(电子版),2017,10(5):604-607.
[9]Mauritz GJ,Rizopoulos D,Groepenhoff H,et al.Usefulness of serial N-terminal pro-B-type natriuretic peptide measurements for determining prognosis in patients with pulmonary arterial hypertension[J].Am J Cardiol,2011,108(11):1645-1650.
[10]Belly MJ,Tiede H,Morty RE,et al.Hb Alc in pulmonary arterial hypertension:a marker of prognostic relevance?[J]Heart Lung Transplant,2012,31(10):1109-1114.
[11]Taguchi H1,Kataoka M,Yanagisawa R,et al.Platelet level as a new prognostic factor for idiopathic pulmonary arterial hypertension in the era of combination therapy[J].Circ J,2012,76(6):1494-1500.
[12]Bajaj A,Rathor P,Sehgal V,et al.Risk stratification in acute pulmonary embolism with heart-type fatty acid-binding protein:A meta-analysis[J].J Crit Care,2015,30(5):1151-1157.
[13]Lankeit C,Dellas A,Panzenbock A,et al.Heart-type fatty acid-binding protein for risk assessment of chornic throm boembolic pulmonary hypertension[J].Eur Respir J,2008,31(5):1024-1029.
[14]Naito A,Tanabe N,Jujo T,et al.Pentraxin3 in chronic thromboembolic pulmonary hypertension:a new biomarker for screening from remitted pulmonary thromboembolism[J].PLo S One,2014;9(11):e113086.
[15]王吉耀,廖二元.内科学(八年制)[M].第3版,北京:人民卫生出版社,2015,124-125.