慢性心力衰竭脂代谢指标与炎性因子表达和左心室重构相关分析  

Correlation between lipid metabolism indicators with inflammatory cytokine expression and left ventricular remodeling in chronic heart failure

作　　者：张宾 尹鹏帆 石金铮[1] 洪洋 孟丑栓 马芳芳[2] 李永乐[3] ZHANG Bin;YIN Peng-fan;SHI Jin-zheng;HONG Yang;MENG Chou-shuan;MA Fang-fang;LI Yong-le(Cardiovascular Department,First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Cardiovascular Department,First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050030,China;Cardiovascular Department,General Hospital of Tianjin Medical University,Tianjin 300302,China)

机构地区：[1]河北北方学院附属第一医院心血管内科,河北省张家口市075000 [2]河北医科大学第一医院心血管内科 [3]天津医科大学总医院心血管内科

出　　处：《中国心血管病研究》2025年第2期158-163,共6页Chinese Journal of Cardiovascular Research

基　　金：河北省卫建委2024年政府资助临床医学优秀人才培养项目(ZF2024226)。

摘　　要：目的探究慢性心力衰竭患者脂代谢指标、丝氨酸蛋白酶抑制剂(Vaspin)、摄食抑制因子1、脂联素与C反应蛋白(CRP)、白细胞介素-6(IL-6)水平及左心室重构关系。方法研究对象选取河北北方学院附属第一医院2023年12月至2024年6月收治的慢性心力衰竭患者合计246例,根据患者是否合并左心室重构将所有患者分为对照组(121例)及重构组(125例)。比较两组患者左心室重构相关参数及脂代谢指标、Vaspin、摄食抑制因子1、脂联素、CRP、IL-6水平。使用Logistic多因素回归分系患者左心室重构独立危险因素,使用Pearson相关性模型分析左心室重构相关参数与脂代谢指标、Vaspin、摄食抑制因子1、脂联素、CRP、IL-6水平相关性。结果重构组左心室舒张末期尺寸(LVEDD)、左心室收缩末内径(LVESd)、左心室后壁厚度(LVPWT)、室间隔厚度(IVSTd)、左心室质量指数(LVMI)高于对照组[(76.84±10.54)mm比(67.08±9.47)mm、(78.41±11.38)mm比(65.29±10.44)mm、(17.43±4.02)mm比(12.19±3.45)mm、(17.64±4.11)mm比(12.28±3.51)mm、(149.83±23.19)g/m^(2)比(139.74±21.46)g/m^(2)],左心室射血分数(LVEF)低于对照组[(35.44±7.69)%比(40.18±7.81)%,P<0.05];重构组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)高于对照组[(5.56±1.11)mmol/L比(4.71±1.03)mmol/L、(1.75±0.05)mmol/L比(1.64±0.04)mmol/L、(1.71±0.16)mmol/L比(1.48±0.14)mmol/L、(2.86±0.59)mmol/L比(2.55±0.54)mmol/L,P<0.05];重构组Vaspin、摄食抑制因子1、脂联素低于对照组[(0.49±0.05)mg/ml比(0.73±0.07)mg/ml、(117.04±21.49)pg/ml比(131.57±24.61)pg/ml、(8.36±1.07)mg/比(9.03±1.24)mg/L,P<0.05];重构组CRP、IL-6高于对照组(P<0.05);Logistic多因素回归分析结果显示,TC、TG、LDL-C、HDL-C、Vaspin、摄食抑制因子1、脂联素、CRP、IL-6水平均是引起慢性心力衰竭患者左心室重构独立危险因素(P<0.05);Pearson相关性分析结果显示,LVEDD、Objective To explore the relationship between lipid metabolism index,Vaspin,food intake inhibitor 1,adiponectin,C-reactive protein(CRP),interleukin-6(IL-6)and left ventricular remodeling in patients with chronic heart failure.Methods A total of 246 patients with chronic heart failure admitted to the First Affiliated Hospital of Hebei North University from December 2023 to June 2024 were selected.All patients were divided into control group(121 cases)and remodeling group(125 cases)according to whether they had left ventricular remodeling.The left ventricular remodeling related parameters,lipid metabolism indexes,Vaspin,food intake inhibitor-1,adiponectin,CRP,and IL-6 levels were compared between the two groups.Multivariate Logistic regression was used to identify the independent risk factors of left ventricular remodeling.Pearson correlation model was used to analyze the correlation between left ventricular remodeling related parameters and lipid metabolism indicators,Vaspin,food intake inhibitory factor 1,adiponectin,CRP and IL-6 levels.Results Left ventricular end-diastolic dimension(LVEDD),left ventricular end-systolic diameter(LVESd),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVSTd)and left ventricular mass index(LVMI)were significantly higher in the remodeling group than in the control group[(76.84±10.54)mm vs.(67.08±9.47)mm、(78.41±11.38)mm vs.(65.29±10.44)mm、(17.43±4.02)mm vs.(12.19±3.45)mm、(17.64±4.11)mm vs.(12.28±3.51)mm、(149.83±23.19)g/m^(2) vs.(139.74±21.46)g/m^(2)],and left ventricular ejection fraction(LVEF)was significantly lower than that in the control group[(35.44±7.69)%vs.(40.18±7.81)%,P<0.05].Total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)in remodeling group were higher than those in control group[(5.56±1.11)mmol/L vs.(4.71±1.03)mmol/L、(1.75±0.05)mmol/L vs.(1.64±0.04)mmol/L、(1.71±0.16)mmol/L vs.(1.48±0.14)mmol/L、(2.86±0.59)mmol/L vs.(2.55±0.54)

关 键 词：慢性心力衰竭 脂代谢 Vaspin、摄食抑制因子1、脂联素 炎症因子 左心室重构 

分 类 号：R541.6[医药卫生—心血管疾病]