重症心力衰竭患者血清Adropin和炎性趋化因子水平变化及其与左心室重构和预后的关系  

Changes of serum Adropin and inflammatory chemokine levels in patients with severe heart failure and their relationship with left ventricular remodeling and prognosis

作　　者：范彩逢 王振华 张守彦 马惠芳 陈红英 FAN Cai-feng;WANG Zhen-hua;ZHANG Shou-yan;MA Hui-fang(Department of Ardiology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang Institute of Cardio-Cerebrovascular Diseases,Luoyang Key Laboratory of Cardiac-Cerebro Tissue Injury and Repair Luoyang,Henan 471000;Department of Ultrasound,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang,Henan 471000,China)

机构地区：[1]郑州大学附属洛阳中心医院心血管内科,洛阳市心脑血管疾病研究所,洛阳市心脑组织损伤与修复重点实验室,河南洛阳471000 [2]郑州大学附属洛阳中心医院超声科,河南洛阳471000

出　　处：《热带医学杂志》2020年第4期530-533,541,共5页Journal of Tropical Medicine

基　　金：洛阳市科技计划项目(1820002A)。

摘　　要：目的探讨重症心力衰竭患者血清Adropin和炎性趋化因子水平变化及其与左心室重构和预后的关系。方法选取2017年3月至2018年11月郑州大学附属洛阳中心医院收治的重症心力衰竭(NYHA心功能Ⅱ级、Ⅲ级或Ⅳ级)患者128例行常规抗心力衰竭、厄贝沙坦氢氯噻嗪以及美托洛尔片治疗,3个月1个疗程,患者均连续治疗2个疗程。检测患者治疗前、治疗1个疗程和治疗2个疗程的血浆脑钠肽(BNP)水平、血清Adropin水平、血清趋化因子(CXCL)10、CXCL12、CXCL16、白细胞介素-6(IL-6)等炎性趋化因子水平,以及左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左室短轴收缩率(LVFS)等左心室重构指标水平。统计患者不良心血管事件发生率。并分析患者血清Adropin和炎性趋化因子水平与其左心室重构指标水平以及不良心血管事件发生率的关系。结果与治疗前比较,患者治疗1个疗程和治疗2个疗程的血浆BNP水平、血清Adropin水平、血清CXCL10、CXCL12、CXCL16、IL-6水平以及LVEDD、LVESD均降低,同期LVEF、LVFS升高,差异均有统计学意义(P<0.05)。患者不良心血管事件发生率为16.41%(21/128)。与无不良心血管事件发生患者比较,发生不良心血管事件患者治疗前后的血清Adropin水平、血清CXCL10、CXCL12、CXCL16、IL-6水平均升高,差异均有统计学意义(P<0.05)。相关分析结果显示,重症心力衰竭患者血清Adropin和CXCL10、CXCL12、CXCL16、IL-6水平与血浆BNP水平、LVEDD、LVESD以及不良心血管事件发生率均呈正相关(Adropin:r=0.779、0.731、0.816、0.842;CXCL10:r=0.842、0.859、0.807、0.871;CXCL12:r=0.879、0.813、0.832、0.806;CXCL16:r=0.881、0.794、0.845、0.795;IL-6:r=0.802、0.819、0.872、0.883,P<0.05),与LVEF、LVFS则呈负相关(Adropin:r=-0.792、-0.778;CXCL10:r=-0.773、-0.779;CXCL12:r=-0.815、-0.843;CXCL16:r=-0.876、-0.889;IL-6:r=-0.818、-0.852,P<0.05)。结论重症心力�Objective To investigate the changes of serum Adropin and inflammatory chemokine levels in patients with severe heart failure and their relationship with left ventricular remodeling and prognosis.Methods 128 patients with severe heart failure(NYHA grade II,III or IV)were treated with routine anti-heart failure,irbesartan hydrochlorothiazide and metoprolol tablets,3 months a course,and all patients were treated for 2 consecutive courses.Before treatment,after treated with 1 course of treatment and after treated with 2 courses,the levels of plasma brain natriuretic peptide(BNP),serum Adropin,serum chemokine(CXCL)10,CXCL12,CXCL16,interleukin-6(IL-6)and other inflammatory chemokines levels,as well as left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular fractional shortening rate(LVFS)and other left ventricular remodeling indexes Level of the patients were measured.The rate of adverse cardiovascular events was counted.The relationship between serum levels of Adropin and inflammatory chemokines level with left ventricular remodeling index and rate of adverse cardiovascular events were analyzed.Results Compared with those of before treatment,the after treated with 1 course of treatment and after treated with 2 courses plasma BNP level,serum Adropin level,serum CXCL10,CXCL12,CXCL16 and IL-6 levels,LVEDD and LVESD of the patients decreased,while LVEF and LVFS increased(P<0.05).The rate of adverse cardiovascular events was 16.41%(21/128).Compared with those of patients without adverse cardiovascular events,in patients with adverse cardiovascular events,before and after treatment serum Adropin levels,serum CXCL10,CXCL12,CXCL16 and IL-6 levels increased(P<0.05).Relevant analysis showed that serum Adropin and CXCL10,CXCL12,CXCL16 and IL-6 levels were positively correlated with plasma BNP level,LVEDD,LVESD and rate of adverse cardiovascular events in patients with severe heart failure(Adropin:r=0.779,0.731,0.816,0.842;CXCL10:r=0.8

关 键 词：重症心力衰竭 Adropin 炎性趋化因子 左心室重构 预后 

分 类 号：R541.6[医药卫生—心血管疾病]