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  

Correlation between serum TBA level and ventricular remodeling and inflammatory response in patients with chronic heart failure

作　　者：刘首雄[1] 余有寿 郑华琼 Liu Shouxiong;Yu Youshou;Zheng Huaqiong(Department of Cardiovascular Medicine,Nanping Second Hospital,Fujian,Nanping,354200,China)

机构地区：[1]福建省南平市第二医院心血管内科

出　　处：《当代医学》2019年第33期84-87,共4页Contemporary Medicine

摘　　要：目的分析慢性心力衰竭患者的血清中总胆汁酸(total bile acid,TBA)水平和炎症反应、心室重构之间的关系。方法选取2017年2月至2018年6月本院收治的慢性心力衰竭患者100例,根据美国纽约心脏病协会(New York Heart Association,NYHA)分级标准,将Ⅱ级57例作为CHFⅡ级组,Ⅲ级43例作为CHFⅢ级组,另选取同期来本院体检无慢性心力衰竭症状的健康人群30名作为对照组。对3组行超声心动图检查,测量左室舒张末期内径(LVEDD)和左室收缩末期内径(LVESD),并应用Simpson法计算左室射血分数(LVEF),利用以上数值根据公式计算左心室心肌重量指数(left ventricular mass index,LVMI)。应用放射免疫法检测超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、N末端脑钠肽原(NT-proBNP)和淀粉样蛋白A(serum amyloid A,SAA)水平,酶比色法检测所有入选者血清总胆汁酸(total bile acid,TBA)水平。结果 3组TG、TC对比差异无统计学意义,CHFⅡ级组和CHFⅢ级组患者的AST、ALT升高明显,与对照组比较,差异有统计学意义(P<0.05),CHFⅡ级组和CHFⅢ级组对比差异无统计学意义;CHFⅡ级组和CHFⅢ级组TBA与SAA、hs-CRP与NT-proBNP水平均高于对照组,差异有统计学意义(P<0.05),且TBA与SAA、hs-CRP与NT-proBNP水平随着心功能分级增加而升高;CHFⅡ级组和CHFⅢ级组TBA与LVESD、LVEDD与LVMI水平均高于对照组(P<0.05),且CHFⅢ级组略高于CHFⅡ级组,差异无统计学意义;CHFⅡ级组和CHFⅢ级组LVEF低于对照组(P<0.05),且CHFⅢ级组略低于CHFⅡ级组,差异无统计学意义;CHFⅡ级组和CHFⅢ级组患者TBA与SAA、hs-CRP、NT-proBNP、LVESD、LVEDD与LVMI水平呈现正相关的关系(r=0.26、0.21、0.18、0.27、0.31、0.42,P<0.05);TBA与LVEF呈现负相关的关系(r=-0.29,P<0.05)。结论慢性心力衰竭的患者血清中总胆汁酸(TBA)水平和炎症反应、心室重构密切相关,对慢性心力衰竭患者心功能状况的评估有积极的意义。Objective To analyze the relationship between serum total bile acid(TBA) level, inflammatory response and ventricular remodeling in patients with chronic heart failure. Methods Selection in February 2017 to June 2018 of our hospital, 100 cases of patients with chronic Heart failure, according to the New York Heart Association(New York Heart Association, NYHA) classification standard, the levels Ⅱ 57 cases as CHF Ⅱgroup, Ⅲ level 43 cases as CHF Ⅲ level group, the other selected at the same time to the hospital physical examination without symptoms of chronic heart failure as control group, with 30 cases of healthy people. Three groups of echocardiography, measurement of left ventricular end-diastolic diameter(LVEDD) and left ventricular end systolic diameter(LVESD), and apply the Simpson method to calculate the left ventricular ejection fraction(LVEF), using the above value according to the formula to calculate the left ventricular mass index(LVMI). Hypersensitive c-reactive protein(hscrp), nt-probnp and amyloid A(SAA) levels were detected by radioimmunoassay, and serum total bile acid(TBA) levels were detected by enzyme colloid assay. Results There was no statistically significant difference among three group of TG, TC, CHFⅡ group and CHFⅢ group of patients with AST and ALT elevations, compared with control group, the difference was statistically significant(P<0.05), but there was no statistically significant difference between two groups of patients. CHFⅡ group and CHFⅢ group of associates and SAA, hs-CRP and the NT-proBNP levels are higher than the control group, the difference was statistically significant(P<0.05), and associates with SAA, hs CRP and NT-proBNP level increases with the increase with cardiac function classification;CHFⅡ group and CHFⅢ group of associates and LVESD, LVEDD and LVMI levels were higher than control group(P<0.05), and the CHF Ⅲ grade level higher than CHFⅡ group, but there was no statistically significant difference. CHFⅡ level group and CHF Ⅲ LVEF lower t

关 键 词：慢性心力衰竭 总胆汁酸 心室重构 炎症反应 

分 类 号：R54[医药卫生—心血管疾病]