老年慢性心力衰竭病人血清和肽素水平与炎症因子和心室重构的相关性

doi:10.3969/j.issn.1003-9198.2021.07.010

摘要/Abstract

摘要： 目的探讨老年CHF病人血清和肽素(CPP)水平与炎症因子和心室重构的相关性。方法选取2018年7月至2019年7月本院收治的83例老年CHF病人作为研究对象(CHF组),另选取同期于本院行健康体检的46例老年体检健康者作为对照组。对比2组血清CPP水平与炎症因子hs-CRP、TNF-α、IL-6水平和心室重构相关指标,包括LVEF、左心房内径(LAD)、左心室舒张末期内径(LVEDD)。血清CPP水平与各炎症因子及心室重构相关指标之间的相关性采用Pearson积矩相关分析进行分析。结果 CHF组血清CPP、hs-CRP、TNF-α、IL-6水平及心室重构相关指标LAD、LVEDD水平均较对照组高,而LVEF较对照组低(P<0.01);Pearson相关分析显示,CHF组血清CPP、hs-CRP、TNF-α、IL-6水平与LAD均呈正相关(r=0.683、0.666、0.614、0.595,P=0.028、0.027、0.024、0.019),与LVEDD均呈正相关(r=0.537、0.603、0.612、0.597,P=0.016、0.020、0.022、0.018),与LVEF均呈负相关(r=-0.611、-0.533、-0.604、-0.607,P=0.020、0.016、0.019、0.021)。结论 CHF病人的血清CPP水平与炎症因子水平异常升高,且与心室重构密切相关,检测血清CPP水平与炎症因子hs-CRP、TNF-α、IL-6水平对CHF病人的临床诊断具有重要的辅助作用。

关键词: 慢性心力衰竭, 血清和肽素, 超敏C反应蛋白, 肿瘤坏死因子-α, 白细胞介素-6, 心室重构

Abstract: Objective To investigate the correlation of the levels of serum copeptin (CPP) and the inflammatory factors with the ventricular remodeling in the elderly patients with chronic heart failure (CHF). Methods A total of 83 elderly patients with CHF admitted to our hospital from July 2018 to July 2019 were selected (CHF group), and 46 healthy elderly who underwent physical examination in our hospital during the same period were selected as the control group.The serum level of the CPP, the levels of inflammatory cytokines such as high-senstitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and the indicators related to ventricular remodeling, including left ventricular ejection fraction (LVEF), left artrial diameter (LAD), left ventricular end-diastolic inner diameter (LVEDD) were detected and compared between the two groups. The correlation between serum levels of CPP, inflammatory factors and the ventricular remodeling related indicators was analyzed by Pearson product moment correlation analysis. Results Serum levels of CPP, hs-CRP, TNF-α and IL-6, and the levels of LAD and LVEDD in CHF group were significantly higher than those in the control group (P＜0.01), while the level of LVEF in CHF group was lower than that in the control group (P＜0.01). Pearson correlation analysis showed that the serum levels of CPP,hs-CRP, TNF-α and IL-6 in CHF group were positively correlated with the level of LAD(r=0.683, 0.666, 0.614, 0.595, P=0.028, 0.027, 0.024, 0.019), which were also positively correlated with the level of LVEDD (r=0.537, 0.603, 0.612, 0.597, P=0.016, 0.020, 0.022, 0.018), and were negatively correlated with the level of LVEF (r=-0.611, -0.533, -0.604, -0.607, P=0.020, 0.016, 0.019, 0.021). Conclusions Serum levels of CPP and the inflammatory factors are abnormally increased in the elderly patients with CHF, and closely related to ventricular remodeling. Detection of serum levels of CPP and the inflammatory factors shows an important auxiliary role in the clinical diagnosis of CHF.

Key words: chronic heart failure, serum copeptin, high-sensitivity C-reactive protein, tumor necrosis factor-α, interleukin-6, ventricular remodeling

中图分类号:

R 541.61

蔡婕, 韦伟, 张郁青. 老年慢性心力衰竭病人血清和肽素水平与炎症因子和心室重构的相关性[J]. 实用老年医学, 2021, 35(7): 701-704.

CAI Jie, WEI Wei, ZHANG Yu-qing. Correlation of the levels of serum copeptin and the inflammatory factors with the ventricular remodeling in elderly patients with chronic heart failure[J]. Practical Geriatrics, 2021, 35(7): 701-704.

参考文献

[1] 张海, 黄志文, 张博, 等. 沙库巴曲缬沙坦和盐酸贝那普利片对射血分数降低的心力衰竭患者心室重塑、炎症因子的影响[J].中国医学创新,2020,17(1):36-39.
[2] 张蕾, 李跃, 何立娟, 等. 慢性心力衰竭患者血清TBA水平与心室重构及炎症反应的相关性[J].中国循证心血管医学杂志,2018,10(12):1506-1509.
[3] SHENG X, LIN L, GUO F, et al. Copeptin level in the early prediction of cardiorenal syndrome in rats[J]. Exp Ther Med, 2018, 16(2):937-944.
[4] 单瑞, 杨培根.老年慢性心衰患者血清胆汁酸水平与炎症因子及心室重构的关系[J].天津医药,2018,46(1):42-45.
[5] 乔香瑞, 刘军辉, 花蕊, 等. 循环单核细胞和血浆中GDF-15和NT-proBNP对慢性心力衰竭的诊断及心血管事件的预测价值[J]. 南方医科大学学报, 2019,39(11):1273-1279.
[6] 陈海荣, 潘碧云, 李名兰, 等. 血浆N末端脑钠肽前体与左心室质量指数对老年左心室射血分数正常心力衰竭的意义[J]. 岭南心血管病杂志, 2018, 24(1):66-71.
[7] 朱小山, 张红申, 杨峰, 等. CHF病人血清儿茶酚抑素、和肽素水平与心力衰竭严重程度及短期心血管事件的关系分析[J]. 中西医结合心脑血管病杂志, 2019, 17(4):90-93.
[8] 韩芬, 杨晓, 王运登, 等. N-端脑钠肽前体与炎症因子在心力衰竭合并肺部感染患者中的临床意义[J]. 中华医院感染学杂志, 2018, 11(4):499-503.
[9] VEZZOSI T, SCHOBER K E. Doppler-derived echocardiographic evidence of pulmonary hypertension in cats with left-sided congestive heart failure[J]. J Vet Cardiol, 2019, 23(5):58-68.
[10] SCHURTZ G, LAMBLIN N, BAUTERS C, et al. Copeptin in acute coronary syndromes and heart failure management: State of the art and future directions[J]. Arch Cardiovasc Dis, 2015, 108(6/7):398-407.
[11] 刘红菊.血清内N末端B型脑利钠肽、和肽素水平变化与慢性心力衰竭患者心功能分级的关联性[J].中国卫生工程学,2018,17(6):938-940.
[12] 葛晓平,金小璐. 阿托伐他汀钙对老年慢性心力衰竭患者心功能及炎症因子的影响[J]. 中国老年学杂志, 2018, 38(5):1058-1060.
[13] 陈莉, 逯伟达, 吴媛媛, 等. 沙库巴曲缬沙坦对射血分数降低的心力衰竭Ⅳ级患者生化指标和左心室结构的干预作用[J]. 中华老年医学杂志, 2019, 38(5):525-528.
[14] 李俐, 肖俊会, 毕健成, 等. 老年慢性心力衰竭患者血浆BNP、TNF-α和血清cTnI水平与心室重构指标及心功能的相关性[J]. 中国老年学杂志, 2019, 39(5):1031-1034.
[15] 高玲, 杨婷, 王迪, 等. 强心活力方对慢性心力衰竭大鼠IL-6、TNF-α含量及NF-κB表达的影响[J]. 中华中医药杂志, 2018, 33(3):1070-1073.
[16] 国家老年医学中心国家老年疾病临床医学研究中心, 中国老年医学学会心血管病分会, 北京医学会心血管病学会影像学组. 中国成人心力衰竭超声心动图规范化检查专家共识[J]. 中国循环杂志, 2019, 34(5):11-25.