沉默信息调节因子3及中医湿证评分与尿毒症心肌病的相关性分析

Correlation Analysis of Silent Information Modulator 3 and TCM Dampness Syndrome Score with Uremic Cardiomyopathy

    摘要
  • 摘要:
    目的 探讨沉默信息调节因子3（SIRT3）及中医湿证评分与尿毒症心肌病（UCM）的关系。
    方法 选取2024年9月至2025年11月就诊于连云港市第一人民医院的终末期肾脏病（ESRD）规律透析患者202例，依据纳入与排除标准将患者分为UCM组129例，非UCM组73例。收集并分析2组的一般临床资料、血清SIRT3水平及中医湿证评分，采用Spearman相关性分析法分析各项观察指标与SIRT3水平、中医湿证评分的相关性，Logistic回归模型分析UCM的危险因素，绘制受试者工作特征（ROC）曲线评估各危险因素对UCM的诊断价值。
    结果 与非UCM组相比，UCM组的女性、肾性高血压、冠心病、心功能不全者占比更多，糖化血红蛋白（HbA1c）、B型尿钠肽（BNP）水平及中医湿证评分升高，SIRT3数值水平降低（均P<0.05）。Spearman相关性分析显示，患者血清SIRT3与左心室质量指数（LVMI）、左心室舒张末期内径（LVEDD）、室间隔厚度（IVST）负相关（rs=-0.556，P<0.001；rs=-0.366，P<0.001；rs=-0.333，P<0.001）。Logistic回归分析显示，女性比值比（OR）=2.796，95%置信区间（CI）：1.172~6.671，P<0.05、低水平SIRT3（OR=0.041，95%CI：0.012~0.133）、高水平中医湿证评分（OR=1.032，95%CI：1.000~1.065）与UCM发病相关性强（P<0.05）。ROC曲线分析显示，血清SIRT3的ROC曲线下面积（AUC）=0.901，95%CI：0.846~0.957；中医湿证评分AUC=0.642，95%CI：0.563~0.721；两者联合AUC=0.906，95%CI：0.853~0.958。
    结论 血清SIRT3与UCM发病风险独立相关，中医湿证评分与SIRT3联合预测UCM的效能更优，可为UCM的预测提供参考。

     

    Abstract:
    OBJECTIVE To investigate the relationship between silent information modulator 3 (SIRT3) and TCM dampness syndrome score with uremic cardiomyopathy (UCM).
    METHODS A total of 202 patients with end-stage renal disease (ESRD) undergoing regular dialysis who visited the First People’s Hospital of Lianyungang from September 2024 to November 2025 were selected. According to the inclusion and exclusion criteria, 129 patients were enrolled in the UCM group and 73 in the non-UCM group, respectively. General clinical data, serum SIRT3 levels, and TCM dampness syndrome scores were collected and analyzed for both groups. Spearman correlation analysis was used to analyze the correlation between each observation indicator and SIRT3 levels and TCM dampness syndrome scores. Logistic regression model was used to analyze risk factors for UCM, and receiver operating characteristic (ROC) curves were plotted to assess the diagnostic value of each risk factor for UCM.
    RESULTS Compared with the non-UCM group, the UCM group had a significantly higher proportion of female patients, as well as those with renal hypertension, complicated coronary heart disease and cardiac insufficiency. Meanwhile, the levels of glycated hemoglobin (HbA1c), B-type natriuretic peptide (BNP) and TCM dampness syndrome score were markedly elevated, whereas the SIRT3 level was decreased (all P<0.05). Spearman correlation analysis revealed that serum SIRT3 was negatively correlated with left ventricular mass index (LVMI), left ventricular end-diastolic dimension (LVEDD) and interventricular septum thickness (IVST) (rs=-0.556, P<0.001; rs=-0.366, P<0.001; rs=-0.333, P<0.001). Logistic regression analysis showed that female odds ratio (OR)=2.796, 95% confidence interval (CI): 1.172–6.671, P<0.05, low SIRT3 (OR=0.041, 95% CI: 0.012–0.133), and high TCM dampness syndrome score (OR=1.032, 95% CI: 1.000–1.065) were strongly associated with the incidence of UCM (P<0.05). ROC curve analysis demonstrated that the area under the ROC curve (AUC) of serum SIRT3 was 0.901 (95% CI: 0.846–0.957); the AUC of TCM dampness syndrome score was 0.642 (95% CI: 0.563–0.721); and the combined AUC of both was 0.906 (95% CI: 0.853–0.958).
    CONCLUSION Serum SIRT3 is independently associated with the risk of UCM. The combined efficacy of TCM dampness syndrome score and SIRT3 in predicting UCM is better and can provide a reference for UCM prediction.

     

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