天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (1): 42-45.doi: 10.11958/20170972

• 临床研究 • 上一篇    下一篇

老年慢性心衰患者血清胆汁酸水平与炎症因子及 心室重构的关系

单瑞 1，杨培根 2△   

  1. 1 天津市武清区人民医院心内科（邮编 301700）；2 天津市胸科医院心内科
  • 收稿日期:2017-09-15 修回日期:2017-10-27 出版日期:2018-01-15 发布日期:2018-01-16
  • 通讯作者: 杨培根 E-mail:yangpeigen@163.com
  • 作者简介:单瑞（1988），男，主治医师，硕士，主要从事心血管疾病基础及临床研究

Correlation of serum bile acid concentration with inflammatory cytokines and ventricular remodel in elderly patients with chronic heart failure

SHAN Rui1, YANG Pei-gen2△   

  1. 1 Department of Cardiology, Tianjin Wuqing District People’s Hospital, Tianjin 301700, China; 2 Department of Cardiology, Tianjin Chest Hospital
  • Received:2017-09-15 Revised:2017-10-27 Published:2018-01-15 Online:2018-01-16

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摘要： 目的 分析老年慢性心力衰竭（CHF）患者血清总胆汁酸（BA）水平与炎症因子及心室重构的关系。方 法 82 例 CHF 患者按照 NYHA 心功能分级标准分为 NYHA Ⅱ级（CHF Ⅱ级组）47 例，Ⅲ级（CHF Ⅲ级组）35 例，另 选取无心衰症状，且超声心动图及血清 B 型钠尿肽前体（pro-BNP）未见异常的同期体检者 32 例作为对照组。应用 酶比色法检测所有入选者血清 BA 水平，放射免疫法检测白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平。行 超声心动图检查，测量左室舒张末期内径（LVEDD），并应用 Simpson 法计算左室射血分数（LVEF）。结果 3 组间 IL-6、TNF-α、BA、pro-BNP、LVEDD、LVEF 水平差异均有统计学意义。CHF 组 IL-6、TNF-α、BA、proBNP、LVEDD 水 平均高于对照组，且随着心功能分级增加而升高；而 LVEF 低于对照组，且随着心功能分级增加而降低（均 P＜ 0.05）。BA 与 IL-6、TNF-α、pro-BNP、LVEDD 呈正相关，与 LVEF 呈负相关（均 P＜0.05）。结论 血清 BA 水平与机 体炎症反应及心室重构相关，对于评估 CHF 患者心功能状况具有一定的参考价值。

关键词: 心力衰竭, 心室重构, 白细胞介素 6, 肿瘤坏死因子 α, 胆汁酸, 炎症因子

Abstract: Objective To investigate the correlation of serum total bile acid (BA) with inflammatory cytokines and ventricular remodeling in elderly patients with chronic heart failure (CHF). Methods A total of 82 patients with CHF were divided into mild group (NYHA grade Ⅱ, n=47) and moderate group (NYHA grade Ⅲ, n=35), according to the grade of cardiac function. A total of 32 subjects with normal physical examination during the same period were selected as the control group. Serum levels of BA, IL-6, TNF-α, pro-BNP, LVEDD and LVEF were measured respectively. Results There were significant differences in IL-6, TNF-α, BA, pro-BNP, LVEDD and LVEF between the three groups (all P＜0.05), which were significantly higher in CHF group than those of control group, and which were increased with the increase of cardiac function grade (P＜0.05). The value of LVEF was significantly lower in CHF group than that of control group, and which was decreased with the increase of cardiac function grade (P＜0.05). There were positive correlations between BA, IL-6, TNF-α, pro-BNP and LVEDD (P＜0.05). There was a negative correlation between BA and LVEF (P＜0.05). Conclusion Serum BA level is correlated with inflammation and ventricular remodel, and which has a certain reference value for the evaluation of cardiac function in elderly patients with CHF．

Key words: heart failure, ventricular remodeling, interleukin-6, tumor necrosis factor-alpha, bile acid, inflammation