慢性心力衰竭患者氧化应激及血清GDF11、HO-1水平与心功能指标的相关性分析

Correlation analysis of oxidative stress, serum GDF11 and serum HO-1 levels with cardiac function indexes in patients with chronic heart failure

摘要:

目的 探讨慢性心力衰竭（CHF）患者生长分化因子11（GDF11）、血红素加氧酶-1（HO-1）、氧化应激水平与心功能指标的相关性。方法 选取2021年2月—2023年2月川北医学院附属医院收治的134例CHF患者为研究组，并根据纽约心脏协会心功能分级将其分为3个亚组［Ⅱ级组（47例）、Ⅲ级组（61例）、Ⅳ级组（26例）］。另选取同期于该院体检的70例健康者为对照组。比较研究组与对照组、不同病情严重程度CHF患者的血清GDF11、HO-1、氧化应激指标［谷胱甘肽过氧化物酶3（GSH-Px3）、总抗氧化能力（T-AOC）、晚期蛋白氧化产物（AOPP）、过氧化脂质（LPO）］及心功能指标［脑钠肽（BNP）、心肌肌钙蛋白I（cTnI）、左室舒张末期内径（LVEDD）、左心室质量指数（LVMI）、左心室射血分数（LVEF）］；采用Pearson法分析GDF11、HO-1、氧化应激水平与心功能指标的相关性。结果 研究组GDF11、HO-1水平高于对照组（P <0.05）。研究组GSH-Px3、T-AOC水平低于对照组，AOPP、LPO水平高于对照组（P <0.05）。研究组BNP、cTnI、LVEDD、LVMI水平高于对照组，LVEF水平低于对照组（P <0.05）。Ⅱ级组GDF11、HO-1、AOPP、LPO、BNP、cTnI、LVEDD、LVMI水平低于Ⅲ级组与Ⅳ级组（P <0.05），Ⅲ级组GDF11、HO-1、AOPP、LPO、BNP、cTnI、LVEDD、LVMI水平低于Ⅳ级组（P <0.05），Ⅱ级组GSH-Px3、T-AOC、LVEF水平高于Ⅲ级组与Ⅳ级组（P <0.05），Ⅲ级组GSH-Px3、T-AOC、LVEF水平高于Ⅳ级组（P <0.05）。Pearson相关性分析显示，GDF11、HO-1、AOPP、LPO与BNP、cTnI、LVEDD、LVMI呈正相关，与LVEF呈负相关（P <0.05）；GSH-Px3、T-AOC与BNP、cTnI、LVEDD、LVMI呈负相关，与LVEF呈正相关（P <0.05）。结论 CHF患者GDF11、HO-1、氧化应激水平、心功能均处于异常状态，且GDF11、HO-1、氧化应激水平与心功能之间存在密切联系。

Abstract:

Objective To investigate the correlation between growth differentiation factor 11 (GDF11), heme oxygenase-1 (HO-1), oxidative stress levels, and cardiac function indicators in patients with chronic heart failure (CHF).Methods We selected 134 CHF patients admitted to the affiliated hospital of North Sichuan Medical College from February 2021 to February 2023 as the study group. According to the New York Heart Association functional classification, they were divided into three subgroups [Class Ⅱ (47 cases), Class Ⅲ (61 cases), Class Ⅳ (26 cases)]. Additionally, 70 healthy individuals undergoing health check-ups during the same period were selected as the control group. We compared serum GDF11, HO-1, oxidative stress indicators [glutathione peroxidase 3 (GSH-Px3), total antioxidant capacity (T-AOC), advanced oxidation protein products (AOPP), lipid peroxidation (LPO)], and cardiac function indicators [brain natriuretic peptide (BNP), cardiac troponin I (cTnI), left ventricular end-diastolic diameter (LVEDD), left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF)] between the study and control groups and among CHF patients with different severity levels. Pearson's method was employed to analyze the correlation between GDF11, HO-1, oxidative stress levels, and cardiac function indicators.Results GDF11 and HO-1 levels in the study group were higher than those in the control group (P < 0.05). GSH-Px3 and T-AOC levels in the study group were lower than those in the control group, while AOPP and LPO levels were higher than those in the control group (P < 0.05). BNP, cTnI, LVEDD, LVMI levels in the study group were higher than those in the control group, while LVEF level was lower than that in the control group (P < 0.05). In Class Ⅱ, GDF11, HO-1, AOPP, LPO, BNP, cTnI, LVEDD, LVMI levels were lower than those in Class Ⅲ and Ⅳ (P < 0.05). In Class Ⅲ, GDF11, HO-1, AOPP, LPO, BNP, cTnI, LVEDD, LVMI levels were lower than those in Class Ⅳ (P < 0.05). In Class Ⅱ, GSH-Px3, T-AOC, LVEF levels were higher than those in Class Ⅲ and Ⅳ (P < 0.05). In Class Ⅲ, GSH-Px3, T-AOC, LVEF levels were higher than those in Class Ⅳ (P < 0.05). Pearson correlation analysis showed a positive correlation between GDF11, HO-1, AOPP, LPO, and BNP, cTnI, LVEDD, LVMI, and a negative correlation with LVEF. GSH-Px3 and T-AOC showed a negative correlation with BNP, cTnI, LVEDD, LVMI, and a positive correlation with LVEF (P < 0.05).Conclusion GDF11, HO-1, oxidative stress levels, and cardiac function in CHF patients are in an abnormal state, and there is a close relationship between GDF11, HO-1, oxidative stress levels, and cardiac function.