作者：程菁祎1，沈倩2，封华3，赵耀1，荀顺芹1

单位：

1.215000江苏省苏州市，苏州大学附属第二医院检验科　2.215000江苏省苏州市，苏州大学附属第一医院检验科3.215000江苏省苏州市，苏州工业园区疾病防治中心

Units：

1.Laboratory Department, the Second Affiliated Hospital of Soochow University, Suzhou 215000, China2.Laboratory Department, the First Affiliated Hospital of Soochow University, Suzhou 215000, China3.Suzhou Industrial Park Centers for Disease Control and Prevention, Suzhou 215000, China

关键词：

冠心病；心肌肥厚；沉默信息调节因子3；左心室重量；左心室质量指数；左心室射血分数；预后；影响因素分析

Keywords：

Coronary disease; Cardiac hypertrophy; Silent information regulator 3; Left ventricular mass; Leftventricular mass index; Left ventricular ejection fraction; Prognosis; Root cause analysis

CLC：

R 541.4　R 542.2

DOI：

10.12114/j.issn.1008-5971.2022.00.225

Funds：

江苏省自然科学基金资助项目（BK20181171）

摘要：

目的　探讨冠心病合并心肌肥厚患者沉默信息调节因子3（SIRT3）与心功能指标相关性，并分析患者预后的影响因素。方法　选取2017年1月至2019年1月苏州大学附属第二医院收治的冠心病合并心肌肥厚患者80例为病例组，另选取同时期本院体检健康的志愿者60例为对照组。检测受试者SIRT3及心功能指标〔左心室重量（LVM）、左心室质量指数（LVMI）、左心室射血分数（LVEF）〕。病例组患者随访2年，记录不良心血管事件发生情况。结果　病例组SIRT3、LVEF低于对照组，LVM、LVMI高于对照组（P ＜0.05）。随访2年，80例冠心病合并心肌肥厚患者中，28例纳入预后不良亚组，52例纳入预后良好亚组。预后不良亚组SIRT3、LVEF低于预后良好亚组，LVM、LVMI高于预后良好亚组（P ＜0.05）。Pearson相关分析结果显示，冠心病合并心肌肥厚患者SIRT3与LVM、LVMI呈负相关（r =-0.282，P =0.011；r =-0.242，P =0.031），与LVEF呈正相关（r =0.181，P =0.011）。ROC曲线分析结果显示，SIRT3、LVM、LVMI、LVEF预测冠心病合并心肌肥厚患者预后的最佳截断值分别为1.38 μg/L、202 g、122 g/m2、49.5%。多因素Logistic回归分析结果显示，SIRT3〔OR =1.521，95%CI （1.204，1.921）〕、LVM〔OR =1.952，95%CI（1.354，1.823）〕、LVMI〔OR =1.652，95%CI （1.095，1.823）〕、LVEF〔OR =1.364，95%CI （1.204，1.402）〕为冠心病合并心肌肥厚患者预后的独立影响因素（P ＜0.05）。结论　冠心病合并心肌肥厚患者SIRT3降低，SIRT3与LVM、LVMI呈负相关，与LVEF呈正相关，SIRT3、LVM、LVMI、LVEF对冠心病合并心肌肥厚患者预后具有一定的预测价值，且为冠心病合并心肌肥厚患者预后的独立影响因素。

Abstract：

Objective　To explore the relationship between silent information regulator 3 (SIRT3) and cardiac function indexes in patients with coronary heart disease and myocardial hypertrophy, and to analyze the influencing factors of prognosisof patients.Methods　A total of 80 patients with coronary heart disease and myocardial hypertrophy in the Second Affiliated Hospital of Soochow University from January 2017 to January 2019 were selected as the case group, and 60 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The SIRT3 and cardiac function indexes [left ventricular mass (LVM) , left ventricular mass index (LVMI) , left ventricular ejection fraction (LVEF) ] were measured. The patients in the case group were followed up for 2 years to record the occurrence of adverse cardiovascularevents.Results　SIRT3 and LVEF in the case group were lower than those in the control group, and LVM and LVMI were higher than those in the control group (P < 0.05) . During the 2-year follow-up, 28 of the 80 patients with coronary heart disease and myocardial hypertrophy were included in the poor prognosis subgroup; 52 cases survived without incident and were included in the good prognosis subgroup. SIRT3 and LVEF in the poor prognosis subgroup were lower than those in the good prognosis subgroup, and LVM and LVMI were higher than those in the good prognosis subgroup (P < 0.05) . Pearson correlation analysis showed that the SIRT3 in patients with coronary heart disease and myocardial hypertrophy was negatively correlated with LVM and LVMI(r =-0.282, P =0.011; r =-0.242, P =0.031) , and positively correlated with LVEF (r =0.181, P =0.011) . ROC curve analysis showedthat the best cut-off values of SIRT3, LVM, LVMI and LVEF for predicting the prognosis of patients with coronary heart disease and myocardial hypertrophy were 1.38 μg/L, 202 g, 122 g/m2 and 49.5% respectively. Multivariate Logistic regression analysis showed that SIRT3 [OR =1.521, 95%CI (1.204, 1.921) ] , LVM [OR =1.952, 95%CI (1.354, 1.823) ] , LVMI [OR =1.652, 95%CI(1.095, 1.823) ] , LVEF [OR =1.364, 95%CI (1.204, 1.402) ] were independent influencing factors of prognosis in patients with coronary heart disease and myocardial hypertrophy (P < 0.05) .Conclusion　SIRT3 in patients with coronary heart disease and myocardial hypertrophy is significantly increased, and it is negatively correlated with LVM and LVMI, positively correlated with LVEF, SIRT3, LVM, LVMI, LVEF have certain predictive value for the prognosis of patients with coronary heart disease andmyocardial hypertrophy, and are the independent influencing factors of prognosis in patients with coronary heart disease and myocardial hypertrophy.

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