三类射血分数保留的心力衰竭患者血清炎症因子水平高表达的影响因素分析  

Influence factor analysis of high expression of inflammatory factor in three types ejection fraction preserved heart failure patients

作　　者：何显菁[1] 包强 詹源胜[1] 陈华昌 吴杏起 HE Xianjing;BAO Qiang;ZHAN Yuansheng;CHEN Huachang;WU Xingqi(Department of Cardiovascular Medicine,Beihai People’s Hospital,Beihai,Guangxi 536000,China)

机构地区：[1]北海市人民医院心血管内科,广西北海536000

出　　处：《医药前沿》2023年第14期5-11,共7页Journal of Frontiers of Medicine

基　　金：北海市科技局基金项目(2020165015)。

摘　　要：目的:分析三类射血分数保留的心力衰竭(HFpEF)患者血清炎症因子水平高表达的影响因素。方法:选取2021年7月—2022年12月北海市人民医院心血管内科收治的三类HFpEF患者共107例,按照葛氏分型分为血管疾病相关HFpEF组(HFpEF-1组)40例,右心和肺相关HFpEF组(HFpEF-3组)29例,瓣膜和节律相关HFpEF组(HFpEF-4组)38例。选取同期健康体检者33例为对照组。分析HFpEF患者血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-1β(IL-1β)、C反应蛋白(CRP)高表达的影响因素。结果:①HFpEF-1组TNF-α、CRP水平与对照组比较,差异有统计学意义(P<0.05)。HFpEF-1组年龄、性别、NYHA分级、房颤史、高血压史、糖尿病史、氨基末端脑钠肽前体(NT-proBNP)、同型半胱氨酸(HCY)、D-二聚体、白细胞数、中性粒细胞百分比、淋巴细胞百分比、肌酐、尿酸、肌酸激酶同工酶(CK-MB)、总胆固醇、低密度脂蛋白胆固醇、空腹血糖、左心房内径(LAD)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、室间隔厚度(IVSD)、左室射血分数(LVEF)与对照组比较,差异有统计学意义(P<0.05)。年龄与TNF-α水平呈负相关(P<0.05)。②HFpEF-3组TNF-α、IL-6、IL-1β、CRP水平与对照组比较,差异有统计学意义(P<0.05)。HFpEF-3组年龄、NYHAⅠ、Ⅲ、Ⅳ级比例、房颤史、NT-proBNP、HCY、D-二聚体、中性粒细胞百分比、淋巴细胞百分比、尿素氮、肌酐、尿酸、LA、IVSD、RVD、肺动脉压与对照组比较,差异有统计学意义(P<0.05)。HFpEF-3组中性粒细胞百分比与TNF-α、IL-6及CRP水平均呈负相关(P<0.05);HFpEF-3组淋巴细胞百分比与TNF-α水平呈正相关(P<0.05)。③HFpEF-4组IL-6、CRP水平与对照组比较,差异有统计学意义(P<0.05)。HFpEF-4组年龄、NYHA分级、房颤史、NT-proBNP、HCY、D-二聚体、中性粒细胞百分比、淋巴细胞百分比、肌酐、尿酸、LA、LVESD、IVSD、1~2个瓣膜病变的比例、LVEF等�Objective To analyze the influence factor of high expression of inflammatory factor in three types ejection fraction preserved heart failure patients.Methods A total of 107 patients with three types of HFpEF admitted to the Cardiovascular Department of Beihai People’s Hospital from July 2021 to December 2022 were selected.They were divided into vascular disease related HFpEF group(HFpEF-1 group)with 40 cases,right heart and lung related HFpEF group(HFpEF-3 group)with 29 cases,and valve and rhythm related HFpEF group(HFpEF-4 group)with 38 cases according to Ge’s classification.33 healthy individuals who underwent physical examination during the same period were selected as the control group.Analyze the influencing factors of high expression of serum tumor necrosis factor-α(TNF-α),Interleukin-6(IL-6),Interleukin-1β(IL-1β)and C-reactive protein(CRP)in HFpEF patients.Results①TNF-αand CRP levels were statistically significantly different in HFpEF-1 group compared to the control group(P<0.05).Age,sex,NYHA grade,atrial fibrillation history,hypertension history,diabetes history,N-terminal pro brain natriuretic peptide(NT-proBNP),homocysteine(HCY),D-dimer,white blood cell count,neutrophil percentage,lymphocyte percentage,creatinine,uric acid,creatine kinase isoenzyme(CK-MB),total cholesterol,low-density lipoprotein cholesterol,fasting blood glucose,left atrial diameter(LAD),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),interventricular septal thickness at diastole(IVSD),and left ventricular ejection fraction(LVEF)of HFpEF-1 group were significantly different from the control group(P<0.05).Age and TNF-αlevel is negatively correlated(P<0.05).②TNF-α,IL-6,IL-1βand CRP levels were statistically significantly different in HFpEF-3 group compared to the control group(P<0.05).Age,proportion of NYHA grades I,III,and IV,history of atrial fibrillation,NT-proBNP,HCY,D-dimer,percentage of neutrophils,percentage of lymphocytes,urea nitrogen,creatinine,uric acid,LA,IVSD,RVD,a

关 键 词：射血分数保留的心力衰竭 TNF-Α IL-6 IL-1Β CRP 

分 类 号：R541.6[医药卫生—心血管疾病]