老年冠心病心力衰竭患者血清IL-8、Hcy、CRP水平与心室重构及预后的关系  

Relationship among serum IL-8,Hcy,CRP levels,ventricular remodeling and prognosis in aged patients with coronary heart failure and heart failure

作　　者：王进 王蓉[1] 陆蕙[1] WANG Jin;WANG Rong;LU Hui(Department of Cardiology,Beijing Aerospace General Hospital,Beijing,100076,China)

机构地区：[1]北京航天总医院心内科,北京100076

出　　处：《心血管康复医学杂志》2023年第6期569-574,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨老年冠心病(CHD)合并心力衰竭(HF)患者血清白介素-8(IL-8)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)水平与心室重构及预后的关系。方法:选择本院收治的180例老年CHD合并HF患者为研究对象,检测所有患者血清IL-8、Hcy、CRP水平及左室重构相关参数,采用Pearson相关性分析血清IL-8、Hcy、CRP与心室重构的相关性。纳入患者均给予针对性强心治疗,随访6个月,根据患者是否发生主要心血管不良事件(MACE)分为预后不良组(45例)及预后良好组(135例),分析血清IL-8、Hcy、CRP水平与预后的关系。结果:随着NYHA分级升高,老年CHD合并HF患者血清IL-8、Hcy、CRP水平和左室后壁厚度(LVPWT)、室间隔厚度(IVST)、左室质量指数(LVMI)均显著增加,左室舒张末期内径(LVEDd)、左室射血分数(LVEF)均显著减小(P<0.05或<0.01);Pearson相关分析显示,老年CHD合并HF患者血清IL-8、Hcy、CRP水平均与LVEDd、LVEF呈显著负相关(r=-0.828~-0.770,P均<0.001),与LVPWT、IVST、LVMI呈显著正相关(r=0.680~0.826,P均<0.001)。预后不良组血清IL-8、Hcy、CRP水平均显著高于预后良好组(P均=0.001);ROC曲线显示,血清IL-8、Hcy、CRP单独及联合预测老年CHD合并HF患者发生MACE的AUC分别为0.761、0.792、0.810、0.916,均有较好的预测价值,且联合检测的预测价值最高(P均<0.01)。结论:老年CHD合并HF患者血清IL-8、Hcy、CRP水平显著升高,与患者心室重构和预后不良密切相关,联合检测对预后不良有较好的预测价值。Objective:To explore the relationship among serum levels of interleukin-8(IL-8),homocysteine(Hcy),Creactive protein(CRP),ventricular remodeling and prognosis in aged patients with coronary heart disease(CHD)and heart failure(HF).Methods:A total of 180 agedCHD+HF patients treated in our hospital were selected.Serum levels of IL-8,Hcy and CRP,and related indexes of left ventricular remodeling were measured.Pearson correlation analysis was used to analyze the correlation among serum IL-8,Hcy,CRP and ventricular remodeling.All the included patients were given targeted cardiotonic therapy and followed up for six months.According to presence of major adverse cardiovascular events(MACE)during follow-up,they were divided into poor prognosis group(n=45)and good prognosis group(n=135).The relationship among serum IL-8,Hcy,CRP levels and prognosis was analyzed.Results:As NYHA class increased,there were significant rise in serum levels of IL-8,Hcy and CRP,left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST)and left ventricular mass index(LVMI),and significant reductions in left ventricular end-diastolic diameter(LVEDd)and LVEF in aged CHD+HF patients,P<0.05 or<0.01;Pearson correlation analysis indicated that serum levels of IL-8,Hcy,CRP were significant inversely correlated with LVEDd and LVEF(r=-0.828~-0.770,P<0.001 all),and significant positively correlated with LVPWT,IVST and LVMI(r=0.680~0.826,P<0.001 all)in aged CHD+HF patients.Serum levels of IL-8,Hcy and CRP in poor prognosis group were significantly higher than those of good prognosis group,P=0.001 all.ROC curve indicated that AUC of serum IL-8,Hcy,CRP and their combined detection was 0.761,0.792,0.810 and 0.916 respectively in predicting MACE during follow-up in these patients,and all possessed good predictive value,among which combined detection possessed the highest predictive value,P<0.01 all.Conclusion:Serum levels of IL-8,Hcy and CRP significantly increase in aged CHD+HF patients,which are closely related to ventricular remod

关 键 词：冠心病 心力衰竭 心室重构 

分 类 号：R541.409[医药卫生—心血管疾病]