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

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

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NYHAⅡ级(CHFⅡ级组)47例,Ⅲ级(CHFⅢ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、pro BNP、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。

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