慢性心力衰竭患者血红蛋白与血清可溶性细胞间黏附分子-1及心功能的关系  

Relationship of hemoglobin levels with serum soluble intercellular adhesion molecule-1 and heart function in patients with chronic heart failure

作　　者：何玉辉[1] 姚晨姣[2] 向芳[1] 赵智[1] 熊斌[1] 

机构地区：[1]武警湖南总队医院内二科,湖南长沙410006 [2]中南大学湘雅三医院血液科,湖南长沙410006

出　　处：《新乡医学院学报》2009年第5期476-479,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨慢性心力衰竭(CHF)患者血红蛋白(Hb)与血清可溶性细胞间黏附分子-1(sICAM-1)及心功能的关系。方法98例CHF患者参照美国纽约心脏协会分级法分为轻中度心力衰竭组48例和重度心力衰竭组50例;并依据Hb水平将CHF患者又分为贫血组30例和非贫血组68例,以健康体检者30例作为对照组,比较各组左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、Hb水平、血清sICAM-1水平,并分析其相关性。结果重度心力衰竭组贫血患病率(40.00%)高于轻中度心力衰竭组(20.83%),差别有统计学意义(P<0.05);重度心力衰竭组Hb水平明显低于轻中度心力衰竭组和对照组(P<0.05);轻中度心力衰竭组血清sICAM-1水平及LVEDD均高于对照组(P<0.05),但低于重度心力衰竭组(P<0.05);轻中度心力衰竭组LVEF与对照组比较差别无统计学意义(P>0.05),但高于重度心力衰竭组(P<0.05)。贫血组血清sICAM-1水平和LVEDD值明显高于非贫血组(P<0.05),而LVEF值明显低于非贫血组(P<0.05)。一元线性相关与回归分析显示,心力衰竭患者Hb水平与LVEDD和sICAM-1呈负相关(P<0.05),Hb水平与LVEF呈正相关(P<0.05)。结论CHF患者常伴有贫血,贫血的程度与心力衰竭的严重程度及血清sICAM-1水平有关,sICAM-1的过度表达可能参与了CHF及贫血的发生和发展过程。Objective To observe the relationship among hemoglobin （Hb） levels, serum soluble intercellular adhesion molecule-1 and heart function in patients with chronic heart failure（CHF）. Methods According to the grading method of New York Heart Association ,98 cases with CHF were divided into slight and moderate heart failure group （48 cases） and severe heart failure group （50 cases） ,and at the same time,they were also divided into anemia group（30 cases） and non-anemia group （68 cases） according to the Hb levels. With 30 healthy people as the control group, data such as left ventricular ejection fraction （LVEF） ,left ventricular end diastolic diameter（ LVEDD）, Hb level and serum concentration of soluble intercellular adhesion molecule-1 （ sICAM-1 ） were compared among the groups, and their correlation was analyzed. Results The anemia rate in the severe heart failure group （40.00%） was higher than that in the slight and moderate heart failure group （20.83%） （P 〈 0. 05） ;The Hb levels in the severe heart failure group was much lower than that in the slight and moderate heart failure group and the control group（P 〈0.05） ;the serum levels of sICAM-1 and LVEDD in the slight and moderate heart failure group were both higher than those in control group （ P 〈 0.05 ）, but lower than those in the severe heart failure group （ P 〈 0.05 ） ; The serum levels of sICAM-1 and LVEDD in the anemia group were obviously higher than those in the non-anemia group （P 〈 0. 05）, but LVEF was obviously lower than that in the non-anemia group （ P 〈 0.05 ）. The monophyletic linear correlation and regression analysis indicated that the Hb level was of negative correlation with LVEDD and sICAM-1 in the heart failure patients （ P 〈 0. 05 ）, but it was of positive correlation with LVEF （ P 〈 0.05 ）. Conclusion Patients with CHF could often suffer from anemia. The degree of anemia is correlated with the severity of heart failure and serum level of sICAM-1. The o

关 键 词：心力衰竭 贫血 血红蛋白 细胞间黏附分子-1 心功能 

分 类 号：R541.61[医药卫生—心血管疾病]