摘要
目的探讨血清表皮生长因子受体(EGFR)、晚期糖基化终末产物受体(RAGE)与重度慢性缺血性二尖瓣关闭不全(CIMR)患者二尖瓣成形术后远期预后的关系。方法选取2015年1月-2018年6月于南宁市第一人民医院行二尖瓣成形术的164例重度CIMR患者为研究对象,随访3年,按预后情况将其分为预后良好组(n=104)、预后不良组(n=60)。比较两组预后不同的重度CIMR患者临床资料及血清EGFR、RAGE水平;分析影响重度CIMR患者二尖瓣成形术后预后不良的因素;分析血清EGFR、RAGE预测重度CIMR患者二尖瓣成形术后预后不良的价值。结果预后不良组重度CIMR患者二尖瓣瓣环扩张占比、血清EGFR、RAGE水平高于预后良好组,左室射血分数(LVEF)水平低于预后良好组,差异均有统计学意义(χ^(2)/t=9.703、10.252、10.354、10.211,P均<0.05)。EGFR、RAGE是重度CIMR患者二尖瓣成形术后预后不良的危险因素(P<0.05),LVEF是重度CIMR患者二尖瓣成形术后预后不良的保护因素(P<0.05)。血清EGFR、RAGE预测重度CIMR患者二尖瓣成形术后预后不良的曲线下面积(AUC)分别为0.864、0.891,其截断值分别为12.88 ng/mL、11.35μg/L,灵敏度均为0.883,特异性分别为0.750、0.799;二者联合预测重度CIMR患者二尖瓣成形术后预后不良的AUC为0.941,其灵敏度为0.867,特异性为0.904。结论二尖瓣成形术后预后不良的重度CIMR患者血清EGFR、RAGE水平较高,EGFR、RAGE联合检测可提高预测重度CIMR患者预后的价值,为临床预测重度CIMR患者预后提供新思路。
Objective To investigate the relationship between serum epidermal growth factor receptor(EGFR),receptor of advanced glycation endproducts(RAGE)and long-term prognosis of patients with severe chronic ischemic mitral regurgitation(CIMR)after mitral valvuloplasty.Methods From January 2015 to June 2018,164 patients with severe CIMR who underwent mitral valvuloplasty in our hospital were selected as the research objects.The patients were followed up for 3years and divided into a good prognosis group(n=104)and a poor prognosis group(n=60)according to the prognosis.The clinical data and serum EGFR and RAGE levels were compared among severe CIMR patients with different prognosis in the two groups;the factors affecting the poor prognosis of severe CIMR patients after mitral valvuloplasty were analyzed;the value of serum EGFR and RAGE in predicting the poor prognosis of severe CIMR patients after mitral valvuloplasty was analyzed.Results The proportion of mitral valve annulus expansion,levels of serum EGFR and RAGE in the poor prognosis group were higher than those in the good prognosis group,and the left ventricular ejection fraction(LVEF)level was lower than that in the good prognosis group(χ^(2)/t=9.703,10.252,10.354,10.211,all P<0.05).EGFR and RAGE were risk factors for poor prognosis after mitral valvuloplasty in severe CIMR patients(P<0.05),and LVEF was a protective factor for poor prognosis after mitral valvuloplasty in severe CIMR patients(P<0.05).The area under the curve(AUC)of serum EGFR and RAGE predicting poor prognosis of severe CIMR patients after mitral valvuloplasty were 0.864 and 0.891,respectively,and their cut-off values were 12.88 ng/mL and 11.35μg/L,respectively;the sensitivity of serum EGFR and RAGE was the same 0.883,and the specificities were 0.750 and 0.799,respectively;the AUC of the combination of the two predicting the poor prognosis of severe CIMR patients after mitral valvuloplasty was 0.941;the sensitivity was 0.867,and the specificity was 0.904.Conclusions Severe CIMR patients with poor prognosis after mitral valvuloplasty had higher serum EGFR and RAGE levels.The combination of EGFR and RAGE could improve the value of predicting the prognosis of severe CIMR patients and provide new ideas for clinical prediction of the prognosis of severe CIMR patients.
作者
郑晓宇
刘永春
蒋斌
邬少君
张迎春
叶仕高
ZHENG Xiao⁃yu;LIU Yong⁃chun;JIANG Bin;WU Shao⁃jun;ZHANG Ying⁃chun;YE Shi⁃gao(Department of Thoracic and Cardiovascular Surgery,the First People's Hospital of Nanning,Nanning,Guangxi 530021,China)
出处
《热带医学杂志》
CAS
2022年第8期1113-1117,共5页
Journal of Tropical Medicine
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20170043)
