老龄退行性心脏瓣膜病合并房颤患者血清炎症因子表达水平变化  

Changes of serum inflammatory factors expression in elderly patients with degenerative valvular heart disease complicated with atrial fibrillation

作　　者：王叶宝[1] 刘玲[1] 李建民[1] WANG Ye-bao;LIU Ling;LI Jian-min(Department of Cardiology,Taizhou People's Hospital,Taizhou Jiangsu 225300,China)

机构地区：[1]泰州市人民医院心脏内科

出　　处：《临床和实验医学杂志》2019年第24期2646-2649,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省医学创新团队项目(编号:CXTD2017015)

摘　　要：目的 探讨老龄退行性心脏瓣膜病(SDHVD)合并房颤(AF)患者血清炎症因子表达水平变化。方法 前瞻性选取2017年1月至2018年12月于泰州市人民医院心内科住院年龄≥60岁的130例老年患者作为研究对象,根据彩色超声心动图及心电图检查结果,将研究对象分为退行性心脏瓣膜病合并房颤(SDHVD+AF)组45例、单纯退行性心脏瓣膜病(SDHVD)组45例和无退行性心脏瓣膜病及房颤的对照组40例。进行彩色超声心动图检查,记录左心房内径(LAId)、左心室舒张末期内径(LVEDd)、左心室射血分数(LVEF)及舒张功能参数(E/A ratio)。采用酶联免疫吸附法(ELISA)法测定三组患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)白细胞介素-6(IL-6)和C-反应蛋白(CRP)水平。分析SDHVD+AF组血清TNF-α、IL-1β、IL-6、CRP水平与心功能指标的关系。结果 SDHVD+AF组患者血清炎症因子水平最高,LAId及LVEDd最大,LVEF及E/A最小,与对照组和SDHVD组比较,差异均有统计学意义(P <0. 05)。SDHVD组患者上述指标较对照组变化更明显,差异有统计学意义(P <0. 05)。SDHVD+AF组血清TNF-α、IL-1β、IL-6和CRP水平与LAId和LVEDd呈正相关,与LVEF和E/A呈负相关(P <0. 05)。结论 炎症反应与老龄退行性心脏瓣膜病合并房颤的病程相关,随着炎症因子水平升高,心功能逐渐降低。Objective To investigate the changes of serum inflammatory cytokine expression in patients with senile degenerative heart valve disease complicated with atrial fibrillation.Methods From January 2017 to December 2018,130 elderly patients(≥60 years)in the Department of Cardiology of Taizhou People's Hospital were selected as subjects.According to the results of color echocardiography and electrocardiogram,the subjects were divided into senile degenerative valvular heart disease combined with atrial fibrillation group(SDHVD+AF),simple degenerative heart valve disease group(SDHVD)and the control group of no degenerative valvular heart disease and atrial fibrillation.Color echocardiography was performed to record left auricle internal dimension(LAId),left ventricular end-diastolic dimension(LVEDd),left ventricular ejection fraction(LVEF)and diastolic function parameters(E/A ratio).Serum levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6)and C-reactive protein(CRP)were measured by ELISA.The relationship between serum TNF-α,IL-1β,IL-6 and CRP levels and cardiac function indexes in SDHVD+AF group was analyzed.Results Serum inflammatory factor levels were highest,LAId and LVEDd were the largest,LVEF and E/A were the lowest in SDHVD+AF patients.All of them were statistically significant compared with the control group and SDHCD group(P<0.05).The above indexes of SDHVD group were statistically significant compared with the control group.There was a statistically significant difference between the three groups(P<0.05).The levels of serum TNF-α,IL-1β,IL-6 and CRP in SDHVD+AF group were positively correlated with LAId and LVEDd,and negatively correlated with LVEF and E/A(P<0.05).Conclusion The inflammatory response is associated with the course of senile degenerative heart valve disease complicated with atrial fibrillation.As the level of inflammatory factors increases,cardiac function gradually decreases.

关 键 词：老龄退行性心脏瓣膜病 房颤 炎症因子 心功能 

分 类 号：R54[医药卫生—心血管疾病]