血清氧化三甲胺水平与高龄老年慢性心力衰竭患者心功能相关性分析

Correlation between serum trimethylamine N-oxide level and cardiac function in old-old patients with chronic heart failure

目的探讨高龄老年慢性心力衰竭患者的肠道菌群代谢产物氧化三甲胺(trimethylamine N-oxide,TMAO)与心脏功能的相关性。方法连续纳入2013年1月-2017年2月南京军区南京总医院干部病房一科住院治疗的104例高龄老年慢性心衰患者,分为TMAO<5μmol/L组和TMAO≥5μmol/L组。对两组的临床基本资料、血脂水平、B型钠尿肽前体(N-terminal pro-B-type natriuretic peptide,NT-pro BNP)和左心室射血分数(left ventricular ejection fraction,LVEF)及纽约心功能分级进行分析。结果 TMAO≥5μmol/L组与TMAO<5μmol/L组相比,NT-pro BNP[(5 603.00±770.40)ng/L vs(2 472.00±383.70)ng/L,P=0.019]水平显著升高,LVEF(35.00%±6.50%vs 42.00%±3.20%,P=0.024)显著降低。血浆TMAO水平与NT-pro BNP及心功能分级呈正相关(r=0.73,P<0.01),与LVEF呈负相关(r=-0.58,P<0.01)。结论血浆TMAO水平与老年慢性心力衰竭患者的心功能相关,可能成为评估老年心衰患者心功能的一个重要标记物。

Objective To investigate the correlation between microbiota-dependent metabolite trimethylamine N-oxide（TMAO） and cardiac function in old-old patients with chronic heart failure. Methods One hundred and four old-old patients（age≥80 years）with chronic heart failure were enrolled in the department of geriatrics, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA from January 2013 to February 2017, and they were divided into two groups： TMAO5μmol/L group and TMAO≥5μmol/L group. The basic clinical data, blood lipid levels, N-terminal pro-B-type natriuretic peptide（NT-pro BNP） and left ventricular ejection fraction（LVEF） were analyzed and compared between two groups. Results Compared with TMAO5μmol/L group, the level of NT-pro BNP in TMAO≥5μmol/L group increased significantly [（5 603.00±770.40） ng/L vs（2 472.00±383.70） ng/L, P=0.019], while LVEF decreased significantly（35.00%±6.50% vs 42.00%±3.20%, P=0.024）. Plasma TMAO level was positively correlated with NT-pro BNP（r=0.73, P〈0.01）, and it was negatively correlated with LVEF（r=-0.58, P〈0.01）. Conclusion Plasma TMAO level is associated with cardiac function in old-old patients with chronic heart failure, which may be an important marker of cardiac function in old-old patients with heart failure.