慢性心力衰竭炎症及相关因素的临床研究

Clinical study of inflammation and its related factors in chronic heart failure

目的 探讨慢性心力衰竭患者炎症细胞因子超敏C反应蛋白（hs-CRP）、半乳凝集素-3（Galectin-3）、高敏肌钙蛋白T（hs-cTnT）、贫血的改变其相关性。方法 选取NYHA分级Ⅱ～Ⅳ级的患者110例,测定血清hs-CRP、Galectin-3、血红蛋白（Hb）、hs-cTnT、氨基末端脑钠肽前体（NT-proBNP）水平,心脏彩色B超观察心脏结构及功能。结果 心功能Ⅳ级组hs-CRP、Galectin-3、hs-cTnT及贫血的发生率高于Ⅱ、Ⅲ级组（〈0.05）;心功能Ⅲ级组的发生率也高于Ⅱ级组（〈0.05）。相关性分析显示,hs-cTnT与Galectin-3、hs-CRP呈正相关,Hb与Galectin-3、hs-CRP呈负相关（〈0.01）;分别对hs-cTnT和Hb做多元线性回归,在调整年龄、性别、NT-proBNP、NYHA分级、左室舒张末期内径（LVEDD）、射血分数（EF）、hs-CRP和Galectin-3共8个可能的影响因素后,Hb与Galectin-3呈负相关,hs-cTnT与hs-CRP呈正相关（〈0.05）。结论 随着心功能的恶化,Galectin-3、hs-CRP、hs-cTnT水平及贫血的发生率逐渐升高。慢性心力衰竭贫血和心肌损伤可能与心衰炎症相关。

[Objective] To investigate the changes of hypersensitive C-reactive protein （hs-CRP）, galectin-3, hypersensitive cardiac troponin T （hs-cTnT） and anemia in patients with chronic heart failure （CHF） and their correlations. [Methods] One hundred and ten patients （NYHA ]I-IV） with CHF hospitalized in our department were selected. Levels of hs-CRP, galectin-3, hemoglobin （Hb）, hs-cTnT and N-terminal pro- brain natriuretic peptide （NT-proBNP） were measured respectively in the three groups, and examinations such as echocardiography were used for observation of cardiac structure and function. [Results] Levels of hs-CRP, galectin-3, hs-cTnT and the incidence of anemia in the heart function level IV group were higher than those in the level II and m groups （P 〈 0.05）, while these data in the level m group were higher than those in the level II group （P〈 0.05）. There was a positive correlation between hs-cTnT and hs-CRP, and also hs- cTnT and galectin-3, while Hb was negatively correlated with hs-cTnT and galectin-3 （P 〈 0.01）. Hs-cTnT and Hb were dealt through multiple linear regression separately After adjusting totally eight possible influence factors including age, gender, NT-proBNP, NYHA classification, left ventricular end-diastolic diameter （LVEDD）, EF, hs-CRP and galectin-3, Hb was negatively correlated with galectin-3 while hs-cTnT was posi- tively correlated with hs-CRP （P〈 0.05）. [Conclusions] The worse the cardiac function, the higher the levels of hs-CRP, galectin-3, hs-cTnT and the incidence of anemia. Anemia and myocardial injury are possibly related with inflammation in the chronic heart failure patients.