老年心力衰竭病人血清胆碱酯酶水平与心室重塑的相关性研究

doi:10.3969/j.issn.1003-9198.2023.12.012

摘要/Abstract

摘要： 目的探究血清胆碱酯酶(ChE)水平与老年慢性心力衰竭病人心室重塑的相关性。方法选取我院老年医学科2018年3月至2021年7月住院确诊为慢性心力衰竭且年龄≥70岁的118例病人进行回顾性研究。收集所有病人的ChE、N末端B型钠尿肽前体(NT-proBNP)水平,肝肾功能、营养状况及心功能分级等基线资料。根据ChE水平将病人分为低水平组(＜4000 U/L,50例)及高水平组(≥4000 U/L,68例)。采用超声心动图检查测定左室内径(LVD)、左房内径(LAD)、室间隔厚度(IVST)、左室后壁厚度(LVPEWT)及LVEF,比较2组基线资料及心功能的差异。结果与高水平组相比,低水平组病人Hb、肌酐、BUN、TC水平及LVEF明显偏低,LVD、NT-proBNP水平明显增高,心功能Ⅳ级病人占比明显增多,差异均有统计学意义(P＜0.05或P＜0.01)。Pearson相关分析结果显示,ChE与LVEF呈正相关(r=0.263,P=0.004),与NT-proBNP及LVD呈负相关(r=-0.490,P<0.001;r=-0.233,P=0.011);Spearman相关分析结果显示,ChE与心功能分级呈负相关(r=-0.621,P<0.001)。结论老年心力衰竭病人ChE水平与LVD呈负相关,与LVEF呈正相关,临床可通过检测血清ChE水平评估老年心力衰竭病人的心室重塑情况。

关键词: 胆碱酯酶, 心力衰竭, 心室重塑, 老年人

Abstract: Objective To explore the correlation between serum cholinesterase (ChE) and ventricular remodeling in the elderly patients with chronic heart failure. Methods A retrospective study was conducted in 118 elderly inpatients with chronic heart failure aged ≥70 years from Department of Geriatric Medicine of our hospital from March 2018 to July 2021. The levels of ChE and N-terminal brain natriuretic peptid (NT-proBNP), the baseline data of liver and kidney function, nutritional status and New York Heart Association (NYHA) cardiac function grading were collected. All patients were divided into the low-level group (<4000 U/L, n=50) and the high-level group (≥4000 U/L, n=68) based on the level of ChE. The left ventricular internal diameter (LVD), left atrium diameter (LAD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPEWT) and left ventricular ejection fraction (LVEF) were measured and compared between the two groups. Results Compared with the high-level group, the levels of hemoglobin (Hb), creatinine, blood urea nitrogen(BUN), total cholesterol (TC) and LVEF were lower, while the levels of LVD and NT-proBNP were higher, and the proportion of the patients with grade Ⅳ heart function was significantly increased in the low-level group(all P<0.05 or P<0.01). Pearson correlation analysis showed that ChE was positively correlated with LVEF (r=0.263, P=0.004), and negatively correlated with NT-proBNP and LVD(r=-0.490, P<0.001; r=-0.233, P=0.011).Spearman correlation analysis showed that ChE was negatively correlated with NYHA cardiac function grading (r=-0.621, P<0.001). Conclusions The level of ChE is negatively correlated with LVD, and positively correlated with LVEF in the elderly patients with heart failure.ChE might be helpful for clinical evaluation of ventricular remodeling in the elderly patients with heart failure.

Key words: cholinesterase, heart failure, ventricular remodeling, aged

中图分类号:

R 541.6

任丽艳. 老年心力衰竭病人血清胆碱酯酶水平与心室重塑的相关性研究[J]. 实用老年医学, 2023, 37(12): 1238-1241.

REN Li-yan. Correlation between serum cholinesterase and ventricular remodeling in elderly patients with heart failure[J]. Practical Geriatrics, 2023, 37(12): 1238-1241.

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