肠道菌群代谢产物氧化三甲胺联合左室射血分数在慢性心力衰竭患者预后中的价值  

Prognostic value of trimethylamine oxide combined with left ventricular ejection fraction in patients with chronic heart failure

作　　者：何卫斌[1] 段新杰[1] 王耀辉[1] He Weibin;Duan Xinjie;Wang Yaohui(Department of Cardiology,Pingdingshan first people's Hospital,Pingdingshan 467000,China;不详)

机构地区：[1]平顶山市第一人民医院心内科,平顶山467000

出　　处：《中国循证心血管医学杂志》2021年第4期443-446,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河南省医学科技攻关计划(联合共建项目)(2018021023)。

摘　　要：目的探讨肠道菌群代谢产物氧化三甲胺(TMAO)联合左室射血分数(LVEF)在慢性心力衰竭患者预后中的价值。方法选取2017年1月至2018年6月于平顶山市第一人民医院心内科收治的120例慢性心力衰竭患者(CHF组)和同期100例健康体检者(对照组)作为研究对象,对比两组血浆TMAO和LVEF水平差异。并对CHF组患者随访2年,以主要心血管不良事件(MACE)为终点又将其分为预后良好(无MACE)组(n=75)和预后不良(MACE发生)组(n=45),对比两组血浆TMAO和LVEF水平差异,用Pearson相关法分析TMAO和LVEF的关系,绘制受试工作者曲线(ROC)分析TMAO和LVEF对CHF预后的判断价值。结果与对照组比较,CHF组血浆TMAO水平明显升高,但LVEF水平明显降低,且差异均有统计学意义(P<0.05)。随访2年均无失访,其中预后不良组45例,预后良好组75例;与预后良好组比较,预后不良组血浆TMAO水平明显升高,但LVEF水平明显降低,且差异均有统计学意义(P<0.05)。经Pearson相关分析得知,TMAO和LVEF呈明显负相关(P=0.014),r值为-0.628。绘制ROC曲线图分析,TMAO和LVEF均可判断CHF预后(P<0.05),其中TMAO判断效能略高于LVEF,但差异无统计学意义(P=0.382),TMAO-LVEF两者联合判断效能最佳(P<0.05),敏感性和特异性分别为85.7%和80.6%。结论TMAO联合LVEF对CHF患者预后有较好的判断价值,可供临床参考。Objective To investigate the prognostic value of trimethylamine oxide(TMAO)combined with left ventricular ejection fraction(LVEF)in patients with chronic heart failure.Methods A total of 120 patients with chronic heart failure(CHF group)and 100 healthy subjects(control group)who were admitted to the Department of Cardiology of the first people's Hospital of pingpariyama from January 2017 to June 2018 were selected as the study subjects,and the differences in plasma TMAO and LVEF levels between the two groups were compared.Patients in the CHF group were followed up for 2 years and were further divided into two groups with good prognosis(no MACE)(n=75)and poor prognosis(occurrence of MACE)(n=45)using major adverse cardiovascular events(MACE)as endpoint,then the differences in plasma TMAO and LVEF levels between the two groups were compared,the relationship between TMAO and LVEF was analyzed by Pearson's correlation method,receiver operating curve(ROC)was drawn to analyze the prognostic value of TMAO and LVEF in CHF.Results Compared with the control group,the plasma TMAO level in the CHF group was significantly increased,but the LVEF level was significantly reduced,and the difference was statistically significant(P<0.05).There was no loss during the 2 years of follow-up.Among them,45 cases were in the poor prognosis group and 75 cases were in the good prognosis group.Compared with the good prognosis group,the plasma TMAO level in the poor prognosis group was significantly increased,but the LVEF level was significantly reduced,and the difference was statistically significant(P<0.05).According to Pearson correlation analysis,TMAO and LVEF were significantly negatively correlated(P=0.014),and the r value was-0.628.Draw ROC curve analysis,both TMAO and LVEF can judge the prognosis of CHF(P<0.05).Among them,the judgment power of TMAO is slightly higher than that of LVEF,but the difference is not statistically significant(P=0.382).The combination of TMAO-LVEF has the best judgment Good(P<0.05),the sensitivity and specific

关 键 词：慢性心力衰竭 肠道菌群 氧化三甲胺 左室射血分数 预后 

分 类 号：R541.61[医药卫生—心血管疾病]