sST2在高血压性心脏病中的应用进展

Advances in the Application of sST2 in Hypertensive Heart Disease

摘要: 高血压(Hypertension, HT)是全球最常见的慢性疾病，也是心血管疾病发病和死亡的主要可干预危险因素。世界卫生组织(WHO)最新资料显示，2024年全球30~79岁成人中约有14亿高血压患者，公共卫生负担持续加重。长期血压升高可通过压力负荷增加、神经体液激活、炎症反应和心肌间质纤维化等机制导致高血压性心脏病(Hypertensive Heart Disease, HHD)。可溶性生长刺激表达基因2蛋白(soluble Suppression of Tumorigenicity 2, sST2)是白细胞介素-33 (Interleukin-33, IL-33)/ST2信号通路的重要组成部分，可反映心肌机械应激、炎症活化及纤维化重构过程。近年来研究显示，ST2/IL-33信号通路与多种心血管疾病密切相关，包括缺血性心脏病、瓣膜性心脏病、心肌梗死(MI)、心力衰竭(HF)、心肌炎及心肌病等。在高血压人群中，sST2升高与左心室肥厚(Left Ventricular Hypertrophy, LVH)及向心性肥厚(Concentric Hypertrophy, CH)风险升高相关，提示其可能成为评估高血压心脏重构和风险分层的潜在生物标志物。本文结合本院160位高血压患者的临床研究，综述了sST2的生物学基础以及其在高血压心脏病中的临床研究进展，并探讨了sST2在早期识别高血压靶器官损害及临床管理中的潜在应用价值。

Abstract: Hypertension (HT) is one of the most common chronic diseases worldwide and a major modifiable risk factor for cardiovascular disease morbidity and mortality. According to the latest data from the World Health Organization (WHO), in 2024, approximately 1.4 billion adults aged 30~79 years globally have hypertension, and the public health burden continues to increase. Long-term elevated blood pressure can lead to hypertensive heart disease (HHD) through mechanisms such as increased pressure overload, neurohumoral activation, inflammatory responses, and myocardial interstitial fibrosis. Soluble suppression of tumorigenicity 2 (sST2) is an important component of the interleukin-33 (IL-33)/ST2 signaling pathway and can reflect myocardial mechanical stress, inflammatory activation, and fibrotic remodeling processes. Recent studies have shown that the ST2/IL-33 signaling pathway is closely related to various cardiovascular diseases, including ischemic heart disease, valvular heart disease, myocardial infarction (MI), heart failure (HF), myocarditis, and cardiomyopathy. In hypertensive populations, elevated sST2 levels are associated with an increased risk of left ventricular hypertrophy (LVH) and concentric hypertrophy (CH), suggesting that sST2 may serve as a potential biomarker for evaluating hypertensive cardiac remodeling and risk stratification. This article, based on a clinical study of 160 hypertensive patients from our hospital, reviews the biological basis of sST2 and its clinical research progress in hypertensive heart disease, and discusses its potential application in the early identification of target organ damage and clinical management in hypertension.