右心室功能不全患者β-羟丁酸代谢特征及与临床指标的相关性分析  

Correlation between beta-hydroxybutyric acid metabolic characteristics and clinical indicators in patients with right ventricular dysfunction

作　　者：考国营 徐刚[1] 张颖[1] KAO Guoying;XU Gang;ZHANG Ying(Department of Cardiovascular Medicine,Chongqing Emergency Medical Center/Chongqing University Central Hospital,Chongqing 400010,China)

机构地区：[1]重庆市急救医疗中心/重庆大学附属中心医院心血管内科,重庆400010

出　　处：《检验医学与临床》2024年第14期2094-2097,2101,共5页Laboratory Medicine and Clinic

基　　金：重庆市科卫联合医学科研项目面上项目(2023MSXM081)。

摘　　要：目的 探讨右心室功能不全(RVD)患者β-羟丁酸(β-OHB)代谢特征及与临床指标的相关性。方法 选择2021年10月至2023年10月在该院心血管内科治疗的38例RVD患者纳入病例组。对照组按照年龄、性别、心血管危险因素等进行匹配,最终纳入47例研究对象。根据RVD患者疾病类型将其分为致心律失常性右室心肌病(ARVC)组和肺动脉高压(PAH)组2个亚组。检测并对比所有研究对象的血浆N末端-B型脑钠肽前体(NT-proBNP)及β-OHB水平。采用Pearson相关分析RVD患者β-OHB水平与其他指标的相关性。结果 病例组、对照组在年龄、性别、体质量指数、吸烟,以及合并高血压、高脂血症、糖尿病患者比例等方面比较,差异均无统计学意义(P>0.05);与对照组比较,病例组血浆NT-proBNP和β-OHB水平明显升高(P<0.05)。ARVC组患者的血浆NT-proBNP[(2 126.1±708.9)pg/mL]和β-OHB[(142.4±55.9)μmol/L]水平高于PAH组患者[(688.4±317.7)pg/mL、(30.6±13.8)μmol/L],差异均有统计学意义(P<0.05)。Pearson相关分析显示,血浆β-OHB水平与NT-proBNP(r=0.734,P<0.001)和右心室舒张末期直径(r=0.445,P=0.005)呈正相关,与肺动脉压呈负相关(r=-0.423,P=0.008)。结论 RVD患者血浆β-OHB水平明显升高,尤其是ARVC患者高于单纯PAH患者,提示病理性的右室心肌病患者发生了显著的β-OHB水平改变。Objective To investigate theβ-hydroxybutyric acid(β-OHB)metabolic characteristics and its correlation with clinical indicators in the patients with right ventricular dysfunction(RVD).Methods A total of thirty-eight inpatients with RVD in the Department of Cardiovascular Medicine of this hospital from October 2021 to October 2023 were selected and included in the case group.The control group was matched according to the age,sex and cardiovascular risk factors,and 47 study subjects were finally included.The patients were divided into the arrhythmogenic right ventricular cardiomyopathy(ARVC)subgroup and pulmonary arterial hypertension(PAH)subgroup according to the disease types of RVD patients.Plasma N-terminal B-type natriuretic natriuretic peptide(NT-proBNP)andβ-OHB levels were measured and compared in all study subjects.The Pearson correlation was used to analyze the correlation betweenβ-OHB level and other indicators in RVD patients.Results There were no statistically significant differences in the aspects of age,gender,body mass index,smoking,complicating hypertension,hyperlipidemia and diabetes between the case group and control group(P>0.05).Compared with the control group,the plasma NT-proBNP andβ-OHB levels in the case group were significantly increased(P<0.05),the plasma NT-proBNP level andβ-OHB level in the ARVC subgroup[(2126.1±708.9)pg/mL,(142.4±55.9)μmol/L]were higher than those in the PAH subgroup[(688.4±317.7)pg/mL,(30.6±13.8)μmol/L],with statistically significant differences(P<0.05).The Pearson correlation analysis showed that plasmaβ-OHB level was positively correlated with NT-proBNP levels(r=0.734,P<0.001)and right ventricular end-diastolic diameter(r=0.445,P=0.005),and negatively correlated with pulmonary artery pressure level(r=-0.423,P=0.008).Conclusion The plasmaβ-OHB level is significantly increased in the patients with RVD,especially ARVC patients are much higher than simple PAH patients,suggesting that the significant change ofβ-OHB level in the patients with pathological rig

关 键 词：心力衰竭 Β-羟丁酸 右心功能不全 肺动脉高压 心律失常型心肌病 

分 类 号：R541.6[医药卫生—心血管疾病] R446.1[医药卫生—内科学]