老年舒张性心力衰竭合并肌少症患者可溶性生长刺激表达基因2蛋白、肌红蛋白、白细胞介素-6水平与心功能的相关性

朱琪; 季梅丽; 庄世虹

doi:10.7619/jcmp.20234138

老年舒张性心力衰竭合并肌少症患者可溶性生长刺激表达基因2蛋白、肌红蛋白、白细胞介素-6水平与心功能的相关性

Correlations between soluble growth stimulation expressed gene 2 protein, myoglobin, interleukin-6 levels and cardiac function in elderly patients with diastolic heart failure complicated with sarcopenia

摘要

摘要:
目的探讨老年舒张性心力衰竭(DHF)合并肌少症患者外周血可溶性生长刺激表达基因2蛋白(sST2)、肌红蛋白(Myo)、白细胞介素-6(IL-6)水平与心功能的相关性。
方法将122例DHF患者根据有无肌少症分为DHF合并肌少症组60例和DHF组62例, 另将健康体检者58例、单纯肌少症患者60例分别纳入对照组、单纯肌少症组, 检测各组外周血sST2、Myo、IL-6水平和心功能指标左室射血分数(LVEF)、心排血量(CO)、心率(HR)、每搏输出量(SV)和心脏指数(CI)。采用Pearson相关分析法分析sST2、Myo、IL-6与各心功能指标的相关性。绘制受试者工作特征(ROC)曲线, 分析sST2、Myo、IL-6单独及联合诊断DHF合并肌少症的效能。
结果与对照组、单纯肌少症组相比, DHF组、DHF合并肌少症组sST2、Myo、IL-6水平和HR均升高, LVEF、CO、SV和CI均降低, 差异有统计学意义(P < 0.05); 与DHF组相比, DHF合并肌少症组sST2、Myo、IL-6水平和HR均升高, LVEF、CO、SV和CI均降低, 差异有统计学意义(P < 0.05)。sST2、Myo、IL-6均分别与LVEF、CO、SV、CI呈负相关(P < 0.001), 均与HR呈正相关(P < 0.001); sST2、Myo、IL-6、LVEF、SV是DHF合并肌少症的独立影响因素(P < 0.05); sST2、Myo、IL-6联合诊断DHF合并肌少症的曲线下面积为0.936, 诊断效能优于三者单独检测。
结论老年DHF合并肌少症患者外周血sST2、Myo、IL-6水平显著升高, 且sST2、Myo、IL-6均与心功能指标显著相关, 三者联合检测对DHF合并肌少症的诊断效能较高。

Abstract:
Objective To investigate the relationship between the levels of soluble growth stimulation expressed gene 2 protein (sST2), myoglobin (Myo), interleukin-6 (IL-6) in peripheral blood and cardiac function in elderly patients with diastolic heart failure (DHF) complicated with sarcopenia.
Methods A total of 122 patients with DHF were divided into DHF complicated with sarcopenia group (60 cases) and DHF group (62 cases) according to the presence or absence of sarcopenia. In addition, 58 healthy healthy population with physical examination and 60 patients with sarcopenia alone were included in the control group and sarcopenia alone group, respectively. The levels of sST2, Myo, IL-6 and cardiac function indexesleft ventricular ejection fraction (LVEF), cardiac output (CO), heart rate (HR), stroke volume (SV), and cardiac index (CI)were measured in each group. Pearson correlation analysis was used to analyze the correlations between sST2, Myo, IL-6 and each cardiac function index. Receiver operating characteristic (ROC) curves were drawn to analyze the diagnostic efficacy of sST2, Myo, IL-6 alone and their combination in diagnosing DHF complicated with sarcopenia.
Results Compared with the control groupand the sarcopenia alone group, the levels of sST2, Myo, IL-6 and HR were increased, while LVEF, CO, SV, and CI were decreased in the DHF group and the DHF complicated with sarcopenia group (P < 0.05). Compared with the DHF group, the levels of sST2, Myo, IL-6 and HR were increased, while LVEF, CO, SV, and CI were decreased in the DHF complicated with sarcopenia group (P < 0.05). The sST2, Myo, and IL-6 were negatively correlated with LVEF, CO, SV, and CI (P < 0.001), and positively correlated with HR (P < 0.001). The sST2, Myo, IL-6, LVEF, and SV were independent influencing factors for DHF complicated with sarcopenia (P < 0.05). The area under the curve of combined detection of sST2, Myo, and IL-6 for diagnosing DHF complicated with sarcopenia was 0.936, indicating a better diagnostic efficacy than individual tests.
Conclusion The levels of sST2, Myo, and IL-6 in peripheral blood are significantly increased in elderly patients with DHF complicated with sarcopenia, and these markers are significantly correlated with cardiac function indexes. Combined detection of these three markers has a higher diagnostic efficacy for DHF complicated with sarcopenia.

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