Zhou Qi, Li Jing, Huang Libingxue, Feng Meigan, Ruan Ke, Liu Min
Comprehensive Ward, Tianyou Hospital Affiliated to Wuhan University of Science and Technology No. 9 Tujialing, Wuchang District, Wuhan 430064, Hubei, China.
Internal Medicine-Carddiovarscular Department, Tianyou Hospital Affiliated to Wuhan University of Science and Technology No. 9 Tujialing, Wuchang District, Wuhan 430064, Hubei, China.
Am J Transl Res. 2023 Feb 15;15(2):1334-1342. eCollection 2023.
To detect the level of serum basic fibroblast growth factor (bFGF) in patients with ischemic cardiomyopathy (ICM) and analyze its clinical significance.
This is a prospective study. From June 2018 to June 2021, 244 patients diagnosed with ICM in the department of cardiology of Tianyou Hospital Affiliated to Wuhan University of Science and Technology and 244 healthy people who underwent physical examination in the physical examination center of our hospital during the same period were enrolled as the research subjects. Serum bFGF level was measured by ELISA kit, and the ICM patients were divided into a high bFGF group (180 cases) and a low bFGF group (64 cases) according to the cut-off value 56.83 obtained from X-tile software analysis, and the clinical data of the two groups were compared. In addition, according to the 12-month survival, the patients were grouped into a poor prognosis group (56 cases) and a good prognosis group (188 cases). Then, univariate and multivariate proportional hazards model (COX regression) analyses were applied to analyze the influencing factors of poor prognosis in ICM patients.
In the ICM group, there were more patients with hypertension and diabetes, and patients had higher levels of HbA1c, blood urea nitrogen, creatinine and uric acid, and lower levels of eGFR and bFGF than patients in the control group (P<0.05). The 12-month endpoint event rate in the low bFGF group was 54.69%, which was significantly higher than 11.67% in the high bFGF group (<0.05). The left ventricular ejection fraction (LVEF) in the low bFGF group was significantly lower than that in the high bFGF group, and the bFGF group also had more patients with cardiac function grade IV (P<0.05). Multivariate COX regression analysis showed that age, diabetes, LVEF and low bFGF were independent influencing factors of poor prognosis in patients with ICM (P<0.05). After adjusting for age, diabetes and LVEF, patients with low bFGF had a higher risk of poor prognosis than those with high bFGF (HR=4.416, 95 CI%: 1.977-9.863, P<0.05).
The serum expression of bFGF in ICM patients is low, and the risk of poor prognosis is higher in patients with low bFGF, suggesting that serum bFGF level has a certain value in the prognosis evaluation of ICM patients.
检测缺血性心肌病（ICM）患者血清碱性成纤维细胞生长因子（bFGF）水平，并分析其临床意义。
本研究为前瞻性研究。选取2018年6月至2021年6月在武汉科技大学附属天佑医院心内科确诊为ICM的244例患者以及同期在我院体检中心进行体检的244例健康人作为研究对象。采用酶联免疫吸附测定（ELISA）试剂盒检测血清bFGF水平，根据X-tile软件分析得出的截断值56.83，将ICM患者分为高bFGF组（180例）和低bFGF组（64例），比较两组的临床资料。此外，根据12个月的生存情况，将患者分为预后不良组（56例）和预后良好组（188例）。然后，应用单因素和多因素比例风险模型（COX回归）分析ICM患者预后不良的影响因素。
ICM组高血压和糖尿病患者较多，与对照组相比，患者糖化血红蛋白（HbA1c）、血尿素氮、肌酐和尿酸水平较高，估算肾小球滤过率（eGFR）和bFGF水平较低（P<0.05）。低bFGF组12个月终点事件发生率为54.69%，显著高于高bFGF组的11.67%（P<0.05）。低bFGF组左心室射血分数（LVEF）显著低于高bFGF组，且低bFGF组心功能Ⅳ级患者也更多（P<0.05）。多因素COX回归分析显示，年龄、糖尿病、LVEF和低bFGF是ICM患者预后不良的独立影响因素（P<0.05）。在调整年龄、糖尿病和LVEF后，低bFGF患者预后不良的风险高于高bFGF患者（风险比[HR]=4.416，95%置信区间[CI]：1.977-9.863，P<0.05）。
ICM患者血清bFGF表达较低，低bFGF患者预后不良风险较高，提示血清bFGF水平在ICM患者预后评估中有一定价值。
