血清PTX3、TNF-α、IL-1β、Hcy水平与退行性心脏瓣膜病合并心房颤动病人心功能的相关性  

Relationship between Serum PTX3,TNF-α,IL-1β,Hcy,and Cardiac Function in Degenerative Heart Valvular Disease Patients with Atrial Fibrillation

作　　者：史超 陈可斌 寻增艳 张之栩 于向志 王均志 SHI Chao;CHEN Kebin;XUN Zengyan;ZHANG Zhixu;YU Xiangzhi;WANG Junzhi(Qingdao Chengyang District People′s Hospital,Qingdao 266109,Shandong,China)

机构地区：[1]青岛市城阳区人民医院,山东青岛266109

出　　处：《中西医结合心脑血管病杂志》2021年第21期3768-3771,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：山东省医药卫生科技发展计划项目(No.2017WS158)。

摘　　要：目的探讨退行性心脏瓣膜病(DHVD)合并心房颤动(AF)病人血清正五聚蛋白3(PTX3)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、同型半胱氨酸(Hcy)水平与心功能的相关性。方法选取2017年1月—2020年3月青岛市城阳区人民医院收治的51例DHVD合并AF病人(DHVD合并AF组)和62例为单纯DHVD病人(DHVD组),根据美国纽约心脏病协会(NYHA)标准进行心功能分级,采用超声心动图检测左心室舒张末期内径(LVEDD)、左心房内径(LAD)、左心室射血分数(LVEF)、左心室舒张早期充盈峰最大充盈速度/舒张晚期充盈峰最大峰值速度(E/A)比值。检测血清PTX3、TNF-α、IL-1β、Hcy水平。分析血清PTX3、TNF-α、IL-1β、Hcy与DHVD合并AF病人NYHA心功能分级、超声心动图参数的相关性。结果DHVD合并AF组血清PTX3、TNF-α、IL-1β、Hcy、LVEDD均高于单纯DHVD组(P<0.01),LVEF、E/A比值均低于单纯DHVD组(P<0.05),NYHA分级Ⅲ级+Ⅳ级病人血清PTX3、TNF-α、IL-1β、Hcy水平均高于Ⅰ级+Ⅱ级病人(P<0.05)。Spearman相关分析结果显示,PTX3、TNF-α、IL-1β、Hcy与NYHA心功能分级呈正相关(P<0.05)。Pearson相关性分析显示,PTX3、TNF-α、IL-1β、Hcy与LVEF、E/A比值呈负相关(P<0.05)。结论高水平PTX3、TNF-α、IL-1β、Hcy与DHVD合并AF病人心功能有关,可作为DHVD合并AF病人心功能评估的指标。Objective To investigate the relationship between the levels of serum pentraxin 3(PTX3),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),homocysteine(Hcy),and cardiac function in patients with degenerative heart valvular disease(DHVD)complicated with atrial fibrillation(AF).Methods From January 2017 to March 2020,fifty-one DHVD patients with AF(DHVD with AF group)and 62 patients with DHVD alone(DHVD group)were selected.The New York Heart Association(NYHA)cardiac function standards were used for cardiac function classification.The left ventricular end-diastolic dimension(LVEDD),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),and the ratio of peak early mitral velocity to peak late mitral velocity(E/A ratio)were detected by echocardiography.Serum PTX3,TNF-α,IL-1β,and Hcy levels were measured.The correlation between serum PTX3,TNF-α,IL-1β,Hcy,and NYHA cardiac function classification,and echocardiography parameters were analyzed.Results Serum PTX3,TNF-α,IL-1β,Hcy,and LVEDD in DHVD with AF group were higher than those in DHVD group(P<0.05),and the LVEF and E/A ratio in DHVD with AF group were lower than those in DHVD group(P<0.05).The levels of PTX3,TNF-α,IL-1β,and Hcy in NYHAⅢ+Ⅳgroup were higher than those inⅠ+Ⅱgroup(P<0.05).Spearman correlation analysis showed that PTX3,TNF-α,IL-1β,and Hcy were positively correlated with NYHA classification(P<0.05).Pearson correlation analysis showed that PTX3,TNF-α,IL-1β,and Hcy were negatively correlated with LVEF and E/A ratio(P<0.05).Conclusion The levels of PTX3,TNF-α,IL-1β,and Hcy are related to the cardiac function of DHVD patients with AF,which can be used as the indicators of cardiac function evaluation for patients with DHVD and AF.

关 键 词：退行性心脏瓣膜病 心房颤动 正五聚蛋白3 肿瘤坏死因子-Α 白介素-1Β 同型半胱氨酸 心功能 

分 类 号：R542.5[医药卫生—心血管疾病] R541.75[医药卫生—内科学]