血清孤啡肽水平在慢性缺血性心力衰竭中的预测价值  

The predictive value of serum orphan peptide levels in chronic ischaemic heart failure

作　　者：侯文飞 韩毅[2] HOU Wen-fei;HAN Yi(School of Anesthesiology,Shanxi Medical University,Taiyuan 030000,China;Department of Anesthesiology,the Second Hospital of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学麻醉学院,山西省太原市030000 [2]山西医科大学第二医院麻醉科

出　　处：《中国心血管病研究》2023年第3期229-234,共6页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金资助项目(81400260);山西省青年科技研究基金项目(201701D12111145);山西省基础研究计划项目(20210302123267)。

摘　　要：目的观察慢性缺血性心力衰竭(CIHF)患者血清孤啡肽(N/OFQ)与白细胞介素6(IL-6)的变化,并探讨它们对CIHF的预测价值。方法纳入2021年4月至2022年6月于山西医科大学第二医院心内科入院治疗的CIHF患者60例(心衰组),按照美国纽约心脏病协会(NYHA)心功能分级标准分为Ⅱ级26例、Ⅲ级18例、Ⅳ级16例,和同期非心衰患者60例(对照组)。比较两组N/OFQ、IL-6等差异,分析CIHF的影响因素,比较N/OFQ、IL-6、临床生化指标及心功能评价参数的差异,采用受试者工作特征(ROC)曲线探讨N/OFQ、IL-6水平的变化对CIHF的预测价值。结果心衰组N/OFQ、IL-6、N末端B型利钠肽前体(NT-proBNP)、左心房前后径(LAD)、左心室舒张末期内径(LVEDD)[(6.35±1.23)ng/L比(4.33±1.09)ng/L,(67.87±15.39)ng/L比(46.14±13.88)ng/L,342.39(290.94,1072.57)ng/L比225.04(181.97,298.04)ng/L,(46.39±11.21)mm比(40.15±4.15)mm,(61.95±13.01)mm比(50.12±4.80)mm]高于对照组(P<0.05),并且与心功能Ⅱ级相比,Ⅲ级、Ⅳ级患者的上述指标显著增加(P<0.05)。心衰患者左心室射血分数(LVEF)低于对照组[(0.4021±0.0612)比(0.5063±0.0785),P<0.05]。Logistic回归分析显示,白细胞(WBC)、中性粒细胞(NEUT)、N/OFQ、IL-6是CIHF的影响因素。相关性分析显示,N/OFQ与IL-6呈正相关;N/OFQ、IL-6分别与WBC、NEUT、NT-proBNP、LAD、LVEDD呈正相关,与LVEF呈负相关。N/OFQ、IL-6、NT-proBNP用于预测CIHF发生的ROC曲线下面积分别为0.891、0.873和0.775(P<0.01)。结论血清中N/OFQ与IL-6水平的变化对CIHF具有重要的预测价值。Objective To investigate the changes of serum nociceptin/orphanin FQ(N/OFQ)and interleukin-6(IL-6)in patients with chronic ischemic heart failure(CIHF)and their predictive value for CIHF.Methods 60 patients with CIHF admitted to the Department of Cardiology of the Second Hospital of Shanxi Medical University from April 2021 to June 2022(heart failure group)were classified into 26 cases of classⅡ,18 cases of classⅢand 16 cases of classⅣaccording to the New York Heart Association(NYHA)cardiac function classification,and 60 patients with non-heart failure during the same period as the control group.The differences in N/OFQ and IL-6 between the 2 groups were compared;the influencing factors of CIHF were analyzed;the differences in N/OFQ,IL-6,clinical biochemical indexes and cardiac function evaluation parameters were compared;and explored the predictive value of changes in N/OFQ and IL-6 levels on CIHF using receiver operating characteristic(ROC)curves.Results In the heart failure group,N/OFQ,IL-6,N-terminal B-type natriuretic peptide precursor(NT-proBNP),left atrial anteroposterior diameter(LAD),left ventricular end-diastolic internal diameter(LVEDD)[(6.35±1.23)ng/L vs.(4.33±1.09)ng/L,(67.87±15.39)ng/L vs.(46.14±13.88)ng/L,342.39(290.94,1072.57)ng/L vs.225.04(181.97,298.04)ng/L,(46.39±11.21)mm vs.(40.15±4.15)mm,(61.95±13.01)mm vs.(50.12±4.80)mm]than the control group(P<0.05),and these indices were significantly increased in patients with classⅢandⅣcompared with classⅡcardiac function(P<0.05).Left ventricular ejection fraction(LVEF)was lower in patients with heart failure than in the control group[(0.4021±0.0612)vs.(0.5063±0.0785),P<0.05].Logistic regression analysis showed that white blood cell(WBC),neutrophil(NEUT),N/OFQ and IL-6 were the influencing factors for CIHF.Correlation analysis showed that N/OFQ was positively correlated with IL-6;N/OFQ and IL-6 were positively correlated with WBC,NEUT,NT-proBNP,LAD,LVEDD and negatively correlated with LVEF,respectively.The area under the ROC curve f

关 键 词：心力衰竭 心室功能 左 心肌缺血 白细胞介素6 内啡肽类 

分 类 号：R541.6[医药卫生—心血管疾病]