慢性心功能不全患者血液中D-乳酸与转化生长因子-β1的相关性研究

The relevant research of D-lactic acid levels and transforming growth factor beta 1 in blood of patients with chronic cardiac failure

目的:探讨慢性心功能不全患者血液中D-乳酸浓度与患者按纽约心脏病协会(NYHA)心功能分级、转化生长因子-β1(TGF-β1)和心功能的关系及其临床意义。方法:连续选取医院急诊科随访的62例慢性收缩性心功能不全患者纳入观察组,另选同期门诊体检的50名健康者纳入健康对照组。检测两组全血标本中D-乳酸、TGF-β1浓度;行心脏彩色超声检查,记录试验对象左心射血分数(LVEF)及左室舒张末容积(LVEDV),比较两组受检者D-乳酸浓度、TGF-β1、LVEDV和LVEF差异,并运用双变量分析观察组D-乳酸浓度与TGF-β1,左心室射血分数、左室舒张末容积的相关性。结果:观察组血液中D-乳酸及TGF-β1浓度较健康对照组明显升高,差异有统计学意义(t=7.731,t=7.673;P<0.05);LVEDV较健康对照组增大,而LVEF较健康对照组减少,差异有统计学意义(t=4.782,t=5.373;P<0.05);D-乳酸与TGF-β1和LVEDV值呈正相关,与LVEF值呈负相关。结论:收缩性心功能不全患者,D-乳酸水平可以反映心功能恶化程度,并且与心力衰竭患者血液中炎性因子升高关系密切。

Objective:To explore the relationships of D-lactic acid levels and grade of heart function of NYHA,transforming growth factor beta1(TGF-β1)and heart function in blood of patients with chronic cardiac failure,and research the clinical significance of their relationship.Methods:62patients with chronic cardiac failure were divided into observation group,and50healthy people were divided into control group.The D-lactic acid and TGF-β1 of whole blood sample of the two groups were detected,at the same time,all of subjects underwent cardiac color Doppler ultrasound examination,and the left ventricular ejection fraction(LVEF)and left ventricular end diastolic volume(LVEDV)of them were recorded.And the differences of D-lactic acid,TGF-β1,LVEDV and LVEF between the two groups were analyzed and compared.And then,the correlations of D-lactic acid and TGF-β1,LVEF,LVEDV in observation group were researched by using double variables analysis.Results:The concentrations of D-lactic acid and TGF-β1in the blood of observation group were significantly higher than those of control group(t=7.731,t=7.673,P<0.05),respectively.The LVEDV of observation group was significantly larger than that of control group,while the LVEF of observation group was significantly less than that of control group(t=4.782,t=5.373,P<0.05).And D-lactic acid was positively correlated with TGF-β1and LVEDV,respectively,while it was negative correlated with LVEF.Conclusion:For patients with contractility cardiac failure,the D-lactic acid can reflect deteriorated degree of cardiac function,and it has close relation with the increasing of inflammatory factors in blood of patients with cardiac failure.