在射血分数保留心力衰竭老年患者中衰弱对免疫标志物的影响  

Effect of frailty on immune markers in elderly patients with heart failure with preserved ejection fraction

作　　者：刘凯坤 黄改荣 段红艳 钱鹏 杨新颖 曹选超 Liu Kaikun;Huang Gairong;Duan Hongyan;Qian Peng;Yang Xinying;Cao Xuanchao(Department of Geriatrics,Henan Provincial People's Hospital,People's Hospital of Zhengzhou University,People's Hospital of Henan University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院,郑州大学人民医院,河南大学人民医院老年医学科,郑州450003

出　　处：《中华老年医学杂志》2025年第3期297-302,共6页Chinese Journal of Geriatrics

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210050)。

摘　　要：目的探讨射血分数保留心力衰竭(heart failure with preserved ejection fraction,HFpEF)老年患者衰弱与免疫标志物的相关性。方法横断面研究,选取2021年3月至2023年12月于河南省人民医院老年医学科住院的416例HFpEF老年患者作为研究对象,年龄60~96(73.03±7.41)岁,衰弱评估采用Fried衰弱表型,采集空腹静脉血测定CD4+T淋巴细胞、CD8+T淋巴细胞、CD4+/CD8+比值、免疫球蛋白A、免疫球蛋白M、免疫球蛋白G。采用Spearman相关性分析及多元线性回归分析评估衰弱评分与免疫标志物的相关性。结果Spearman相关性分析结果显示,衰弱评分与CD4+/CD8+比值(r=-0.659,P<0.001)、免疫球蛋白A(r=-0.454,P<0.001)、免疫球蛋白M(r=-0.522,P<0.001)、免疫球蛋白G(r=-0.802,P<0.001)呈负相关;多元线性回归分析结果显示,调整混杂因素后,衰弱评分负向预测CD4+/CD8+比值(β=-0.562,P<0.001)、免疫球蛋白A(β=-0.366,P<0.001)、免疫球蛋白M(β=-0.445,P<0.001)、免疫球蛋白G(β=-0.772,P<0.001),与无衰弱组比较,衰弱组CD4+/CD8+比值(β=-0.666,P<0.001)、免疫球蛋白A(β=-0.514,P<0.001)、免疫球蛋白M(β=-0.526,P<0.001)、免疫球蛋白G(β=-0.814,P<0.001)水平更低。结论在住院的HFpEF老年患者中,衰弱是CD4+/CD8+比值、免疫球蛋白A、免疫球蛋白M、免疫球蛋白G降低的独立危险因素。因此,临床上应提高对老年患者衰弱的认识及重视程度,积极预防和治疗衰弱,可能对预防机体免疫功能紊乱有一定帮助,有利于老年患者的疾病康复。ObjectiveTo investigate the correlation between frailty and immune markers in elderly patients diagnosed with heart failure with preserved ejection fraction(HFpEF).MethodsA total of 416 elderly patients with HFpEF,who were hospitalized in the Department of Geriatrics at Henan Provincial People's Hospital from March 2021 to December 2023,were selected as research subjects.The Fried frailty phenotype was employed to assess frailty.Fasting venous blood samples were collected to measure levels of CD4+T lymphocytes,CD8+T lymphocytes,the CD4+/CD8+ratio,and immunoglobulins A,M,and G.Spearman correlation analysis and multiple linear regression analysis were conducted to evaluate the relationship between frailty scores and immune markers.ResultsSpearman correlation analysis revealed a significant association between frailty score and the CD4+/CD8+ratio(r=-0.659,P<0.001),immunoglobulin A(r=-0.454,P<0.001),immunoglobulin M(r=-0.522,P<0.001),and immunoglobulin G(r=-0.802,P<0.001).Furthermore,multiple linear regression analysis indicated that,after adjusting for confounding factors,frailty score served as a significant negative predictor of the CD4+/CD8+ratio(β=-0.562,P<0.001),immunoglobulin A(β=-0.366,P<0.001),immunoglobulin M(β=-0.445,P<0.001),and immunoglobulin G(β=-0.772,P<0.001).In comparison to the non-frail group,the frail group exhibited significantly lower values for the CD4+/CD8+ratio(β=-0.666,P<0.001)and levels of immunoglobulin A(β=-0.514,P<0.001),immunoglobulin M(β=-0.526,P<0.001),and immunoglobulin G(β=-0.814,P<0.001).ConclusionsIn hospitalized elderly patients with heart failure with HFpEF,frailty serves as an independent risk factor for the reduction of the CD4+/CD8+ratio,as well as levels of immunoglobulin A,immunoglobulin M,and immunoglobulin G.Furthermore,the frailty score demonstrates a significant negative predictive value for these immunological markers.Therefore,it is essential to enhance our understanding of frailty and to prioritize its prevention and treatment,as this may help mitigate immune

关 键 词：心力衰竭 衰弱 免疫标志物 

分 类 号：X70[环境科学与工程—环境工程]