血清金属蛋白酶组织抑制因子4、E选择素及游离脂肪酸水平与慢性心力衰竭患者心功能及预后的相关性研究  

Correlations of Serum Levels of TIMP-4,ES and FFA with Cardiac Function and Prognosis in Patients with Chronic Heart Failure

作　　者：王刚[1] 王娟 魏红随 王彩娟[4] 刘兴芝 杨永利[1] 耿清峰[1] 刘育慧 

机构地区：[1]河北省第七人民医院,河北省定州市073000 [2]河北省定州市中医医院,073000 [3]河北省蠡县医院,071400 [4]河北省石家庄市中医院,050000 [5]河北省定州市妇幼保健院,073000

出　　处：《实用心脑肺血管病杂志》2017年第4期28-32,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：2015年度河北省医学科学研究重点课题计划项目(20150552)

摘　　要：目的分析血清金属蛋白酶组织抑制因子4(TIMP-4)、E选择素(ES)及游离脂肪酸(FFA)水平与慢性心力衰竭患者心功能及预后的相关性。方法选取2015年1—6月在河北省第七人民医院心血管内科住院治疗的慢性心力衰竭患者118例作为观察组,另选取同期在河北省第七人民医院进行体检的体检健康者60例作为对照组。比较两组受试者血常规检查指标,血清TIMP-4、ES、FFA、C反应蛋白(CRP)水平及心功能指标,分析慢性心力衰竭影响因素及血清TIMP-4、ES、FFA水平与慢性心力衰竭患者心功能指标的相关性,并比较不同预后患者血清TIMP-4、ES、FFA水平。结果观察组患者总胆固醇(TC)低于对照组,低密度脂蛋白胆固醇(LDL-C)及白细胞计数(WBC)高于对照组,红细胞沉降率(ESR)快于对照组(P<0.05);两组受试者三酰甘油(TG)比较,差异无统计学意义(P>0.05)。观察组患者血清TIMP-4水平低于对照组,血清ES、FFA及CRP水平高于对照组(P<0.05)。观察组患者左心室舒张末期内径(LVEDD)和左心室内径(LA)大于对照组,左心室射血分数(LVEF)低于对照组(P<0.05)。多因素Logistic回归分析结果显示,血清TIMP-4水平是慢性心力衰竭的保护因素[OR=0.713,95%CI(0.422,0.928)],而血清ES[OR=4.352,95%CI(2.014,6.204)]、FFA[OR=2.304,95%CI(1.025,3.627)]水平是慢性心力衰竭的危险因素(P<0.05)。Pearson相关性分析结果显示,血清TIMP-4水平与慢性心力衰竭患者LA、LVEDD呈负相关(r值分别为-0.372、-0.416,P<0.05),与LVEF呈正相关(r=0.564,P<0.05);血清ES水平慢性心力衰竭患者LA、LVEDD呈正相关(r值分别为0.362、0.421,P<0.05),与LVEF呈负相关(r=-0.427,P<0.05);血清FFA水平与慢性心力衰竭患者LA、LVEDD呈正相关(r值分别为0.376、0.453,P<0.05),与LVEF呈负相关(r=-0.553,P<0.05)。预后不良者血清TIMP-4水平低于预后良好者,血清ES、FFA水平高于预后良好者(P<0.05)。结论血清TIMP-4、ES及FFA水平是慢性心力衰竭的�Objective To analyze the correlations of serum levels of TIMP-4, ES and FFA with cardiac function and prognosis in patients with chronic heart failure. Methods From January to June 2015, a total of inpatients with chronic heart failure were selected as observation group in the Department of Cardiovascular Medicine, the Seventh People＇s Hospital of Hebei Province, meanwhile a total of 60 healthy people admitted to this hospital for physical examination were selected as control group. Blood routine examination results, serum levels of TIMP-4, ES, FFA and CRP, and index of cardiac function were compared between the two groups, influencing factors of chronic heart failure and correlations of serum levels of TIMP-4, ES and FFA with cardiac function in patients with chronic heart failure were analyzed, and serum levels of TIMP-4, ES and FFA were compared in chronic heart failure patients with different prognosis. Results TC of observation group was statistically significantly lower than that of control group, LDL-C and WBC of observation group were statistically significantly higher than those of control group, while ESR of observation group was statistically significantly faster than that of control group （ P 〈 0. 05 ） ; no statistically significant differences of TG was found between the two groups （ P 〉 0. 05 ）. Serum TIMP-4 level of observation group was statistically significantly lower than that of control group, while serum levels of ES, FFA and CRP of observation group were statistically significantly higher than those of control group （ P 〈 0. 05 ）. LVEDD and LA of observation group were statistically significantly larger than those of control group, while LVEF of observation group was statistically significantly lower than that of control group （P 〈0. 05）. Multivariate Logistic regression analysis results showed that, serum TIMP-4 level was the protective factor of chronic heart failure [ OR = 0. 713, 95% CI （0. 422, O. 928） ], while serum levels of ES [ OR = 4. 352, 95% CI （2.

关 键 词：心力衰竭 金属蛋白酶组织抑制因子4 E选择素 游离脂肪酸 心功能 预后 

分 类 号：R541.6[医药卫生—心血管疾病]