老年慢性心力衰竭患者血清炎性因子水平变化及其与心衰标志物和心功能指标的相关性分析  

Changes of Serum Inflammatory Factors in Elderly Patients with Chronic Heart Failure and Their Correlation with Heart Failure Markers and Cardiac Function Indicators

作　　者：杨晓梅 方明明 王艳 刘平 于立成 YANG Xiao-mei;FANG Ming-ming;WANG Yan;LIU Ping;YU Li-cheng(Department of Internal Medicine, Beijing Shangdi Hospital, Beijing 100084,China;Department of Cardiology, Beijing Haidian Hospital, Beijing 100084,China)

机构地区：[1]北京市上地医院内科,北京100084 [2]北京市海淀医院心内科,北京100080

出　　处：《微循环学杂志》2020年第4期60-63,共4页Chinese Journal of Microcirculation

摘　　要：目的:分析老年慢性心力衰竭患者血清炎性因子水平变化及其与心衰标志物和心功能指标的相关性。方法:选择2018-02-2020-02收治的老年慢性心力衰竭患者200例作为观察组,根据NYHA心功能分级再将其分为Ⅱ级组(n=73)、Ⅲ级组(n=65)和Ⅳ级组(n=62)。选择同期体检健康者110例作为对照组。比较各组血清B型脑钠肽(BNP)、血清肌钙蛋白I(cTnI)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、左心室舒张末期内径(LVEDD)和左室射血分数(LVEF)水平,同时分析炎性指标TNF-α、IL-6与心衰指标BNP、cTnI及心功能指标LVEF、LVEDD水平的相关性。结果:观察组患者BNP、cTnI、TNF-α、IL-6、LVEDD均显著高于对照组,而LVEF低于对照组(P<0.01);Ⅲ级组和Ⅳ级组患者BNP、TNF-α、IL-6、cTnI、LVEDD水平均高于Ⅱ级组,而LVEF低于Ⅱ级组(均P<0.01);Ⅳ级组患者的BNP、TNF-α、IL-6、cTnI、LVEDD表达水平均高于Ⅲ级组,而LVEF低于Ⅲ级组(均P<0.01);老年慢性心力衰竭患者的血清炎性因子TNF-α、IL-6与BNP、cTnI、LVEDD水平呈正相关,与LVEF呈负相关(P<0.01)。结论:监测血清炎性因子水平变化亦可为老年慢性心力衰竭患者的诊断、治疗以及预后提供依据。Objective: To analyze the changes of serum inflammatory factors in elderly patients with chronic heart failure and their correlation with heart failure markers and cardiac function indicators.Method: 200 cases of elderly patients with chronic heart failure admitted from February 2018 to February 2020 were selected as the observation group. According to the NYHA cardiac function classification, 73 cases were divided into group Ⅱ, 65 cases in group Ⅲ, and 62 cases in group Ⅳ.During the same period, 110 healthy subjects were selected as the control group. Serum B-type brain natriuretic peptide(BNP), serum troponin(cTnI), serum tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), and left ventricular end-diastolic diameter(LVEDD) and left ventricular ejection fraction(LVEF) levels in each group were detected. At the same time, the correlation between inflammatory indicators TNF-α and IL-6 and heart failure indicators BNP, cTnI and heart function indicators LVEF and LVEDD were analyzed.Results: BNP, cTnI, TNF-α, IL-6, LVEDD in the observation group were significantly higher than the control group,and LVEF was lower than that of the control group(P<0.01).The levels of BNP,TNF-α,IL-6,cTnI,and LVEDD in group Ⅲ and group Ⅳ were higher than those in group Ⅱ,while LVEF was lower than group Ⅱ(all P<0.01).BNP,TNF-α,IL-6,cTnI,and LVEDD in group Ⅳ were higher than those of the group Ⅲ,while the LVEF was lower than group Ⅲ(all P<0.01).Serum inflammatory factors TNF-αand IL-6 were positively correlated with BNP,cTnI and LVEDD in elderly patients with chronic heart failure,and negatively correlated with LVEF(P<0.01).Conclusion:Monitoring the serum inflammatory factor can provide evidence for the diagnosis,treatment and prognosis for eldery patients with chronic heart failure.

关 键 词：慢性心力衰竭 老年 B型脑钠肽 血清肌钙蛋白 血清肿瘤坏死因子Α 白细胞介素-6 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]