慢性心力衰竭患者血清胆汁酸与炎症因子及心功能指标的相关性研究

Correlation between Serum Bile Acid and Inflammatory Factors and Cardiac Function Indexes in Patients with Chronic Heart Failure

目的探讨慢性心力衰竭(CHF)患者血清胆汁酸(BA)与炎症因子及心功能指标的相关性。方法选取2020年9月至2022年4月于石河子大学医学院第一附属医院心内科住院治疗的CHF患者125例,根据美国纽约心脏病协会(NYHA)分级将患者分为CHFⅡ组(n=32)、CHFⅢ组(n=51)、CHFⅣ组(n=42);另外选取同期于本院住院治疗的非心力衰竭患者50例作为对照组。比较四组一般资料〔年龄、性别、饮酒史、吸烟史、BMI、收缩压(SBP)、舒张压(DBP)、合并基础疾病(冠心病、高血压、陈旧性心肌梗死、心房颤动、扩张型心肌病)情况〕、血清BA、炎症因子〔血管性血友病因子(vWF)、内皮素1(ET-1)、超敏C反应蛋白(hs-CRP)〕、心功能指标〔N末端脑钠肽前体(NT-proBNP)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)〕。探讨CHF患者血清BA与vWF、ET-1、hs-CRP、NT-proBNP、LVEF、LVEDD、LVEDV、LVESV的相关性。结果CHFⅣ组血清BA、vWF、ET-1、hs-CRP、NT-proBNP高于对照组、CHFⅡ组、CHFⅢ组,LVEF低于对照组、CHFⅡ组、CHFⅢ组,LVEDD、LVESV大于对照组、CHFⅡ组,LVEDV大于对照组、CHFⅡ组、CHFⅢ组(P<0.05);CHFⅢ组血清BA、vWF、ET-1、hs-CRP、NT-proBNP高于对照组、CHFⅡ组,LVEF低于对照组、CHFⅡ组,LVEDD、LVEDV、LVESV大于对照组、CHFⅡ组(P<0.05);CHFⅡ组血清BA、vWF、ET-1、hs-CRP、NT-proBNP高于对照组,LVEF低于对照组,LVEDD、LVEDV、LVESV大于对照组(P<0.05)。CHF患者血清BA与vWF(rs=0.371)、ET-1(rs=0.394)、hs-CRP(rs=0.418)、NT-proBNP(rs=0.587)、LVEDD(rs=0.446)、LVEDV(rs=0.466)、LVESV(rs=0.473)呈正相关(P<0.001),与LVEF呈负相关(rs=-0.606,P<0.001)。结论CHF患者血清BA与vWF、ET-1、hs-CRP、NT-proBNP、LVEDD、LVEDV、LVESV呈正相关,与LVEF呈负相关,且血清BA与CHF的发生发展及病情严重程度有一定关系。

Objective To investigate the correlation between serum bile acid(BA)and inflammatory factors and cardiac function indexes in patients with chronic heart failure(CHF).Methods A total of 125 patients with CHF who were hospitalized in the Third Department of Cardiology,First Affiliated Hospital,School of Medicine,Shihezi University from September 2020 to April 2022 were selected and divided into CHFⅡgroup(n=32),CHFⅢgroup(n=51)and CHFⅣgroup(n=42)according to the New York Heart Association(NYHA)classification.In addition,50 patients with non-heart failure who were hospitalized the same hospital during the same period were selected as the control group.General data[age,sex,drinking history,smoking history,BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),complicated with underlying diseases(coronary heart disease,hypertension,old myocardial infarction,atrial fibrillation,dilated cardiomyopathy)],serum BA,inflammatory factors[von Willebrand factor(vWF),endothelin-1(ET-1),hypersensitive C-reactive protein(hs-CRP)],cardiac function indicators[N-terminal brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)]were compared among the four groups.The correlation between serum BA and vWF,ET-1,hs-CRP,NT-proBNP,LVEF,LVEDD,LVEDV and LVESV in patients with CHF was investigated.Results Serum BA,vWF,ET-1,hs-CRP and NT-proBNP in CHFⅣgroup were higher than those in control group,CHFⅡgroup and CHFⅢgroup,LVEF was lower than that of control group,CHFⅡgroup and CHFⅢgroup,LVEDD and LVESV were higher than those in control group and CHFⅡgroup,LVEDV was higher than that in control group,CHFⅡgroup and CHFⅢgroup(P<0.05).Serum BA,vWF,ET-1,hs-CRP and NT-proBNP in CHFⅢgroup were higher than those in control group and CHFⅡgroup,LVEF was lower than that in control group and CHFⅡgroup,LVEDD,LVEDV and LVESV were higher than those in control group and CHFⅡgroup(P<0.05).Serum BA,vWF,ET-1,hs-CRP and NT-proBNP in CHFⅡgroup were higher than those in control group,LVEF was lower than that in control group,and LVEDD,LVEDV and LVESV were higher than those in control group(P<0.05).Serum BA of CHF patients was positively correlated with vWF(rs=0.371),ET-1(rs=0.394),hs-CRP(rs=0.418),NT-proBNP(rs=0.587),LVEDD(rs=0.446),LVEDV(rs=0.466)and LVESV(rs=0.473),and negatively correlated with LVEF(rs=-0.606)(P<0.001).Conclusion Serum BA in CHF patients is positively correlated with vWF,ET-1,hs-CRP,NT-proBNP,LVEDD,LVEDV and LVESV,and negatively correlated with LVEF,and serum BA is related to the occurrence and development of CHF and the severity of the disease.