脓毒症并发心力衰竭患者血乳酸、前列腺素-2和缺氧诱导因子-1α水平分析及与微循环功能、心功能损伤的关系

Correlation of Blood Lactate, HIF-1α and PGE2 Levels with Microcirculatory Function and Cardiac Dysfunction in Patients with Sepsis Accompanied by Heart Failure

目的:分析脓毒症并发急性心力衰竭患者血乳酸、前列腺素-2(PGE2)和缺氧诱导因子-1α(HIF-1α)水平的变化及与微循环功能、心功能损伤的关系。方法:本研究采用回顾性研究方法,选取本院2020-03-2023-02确诊的脓毒症且并发急性心力衰竭患者86例(设为A组),另选取同期脓毒症未发生心力衰竭的患者90例(设为B组),检测两组患者确诊脓毒症第1天、第3天、第5天的血乳酸、PGE2和HIF-1α水平,并对比两组患者的超声心动图指标、微循环功能参数,分析脓毒症并发急性心力衰竭患者血乳酸、PGE2、HIF-1α与心功能、微循环功能的相关性。结果:A组患者在第1天、第3天、第5天三个时间点的血乳酸、PGE2、HIF-1α水平均显著高于B组(P<0.01);两组患者在确诊脓毒症后第3天血乳酸、PGE2、HIF-1α达到峰值水平;A组患者的PPV、PVD、MFI、EDV、ESV、SV、LVEF、CO、FS、E/A水平均显著低于B组(P<0.01);脓毒症并发急性心力衰竭患者血乳酸水平与PPV、PVD、MFI、SV、LVEF、E/A水平呈显著负相关,PGE2水平与PPV、PVD、MFI、LVEF、FS测定值呈显著负相关,HIF-1α水平与PPV、PVD、MFI、LVEF、CO、FS测定值呈显著负相关(P<0.05或P<0.01)。结论:脓毒症并发急性心力衰竭患者的血乳酸、PGE2、HIF-1α水平显著升高,且与患者心功能损伤及微循环障碍密切相关。

Objective:To analysis the relationship between blood lactate,prostaglandin-2(PGE2),hypoxia inducible factor-1α(HIF-1α)and microcirculation and cardiac function in patients with sepsis complicated by acute heart failure.Method:86 patients diagnosed with sepsis and complicated with acute heart failure from March 2020 to February 2023 were set as group A,and another 90 patients who did not experience heart failure in sepsis during the same period were set as group B.The blood lactate,PGE2,and HIF-1αlevels of the two groups of patients were measured on the first,third,and fifth day of diagnosis of sepsis.The echocardiographic indicators and microcirculation function parameters between two groups of patients were compared,and the correlation of blood lactate,PGE2 and HIF-1αwith cardiac function and microcirculation function was analyzed.Results:Blood lactate,PGE2 and HIF-1αlevels of group A patients at three time points on day 1,day 3,and day 5 were significantly higher than those of group B,and the differences were statistically significant(P<0.01).Blood lactate,PGE2,and HIF-1 levels in two groups of patients on the third day after diagnosis of sepsis were at peak level.The levels of PPV,PVD,MFI,EDV,ESV,SV,LVEF,CO,FS,and E/A in group A patients were significantly lower than those in group B(P<0.01).The blood lactate levels in patients with sepsis complicated by acute heart failure were significantly negatively correlated with PPV,PVD,MFI,SV,LVEF,E/A(P<0.05 or P<0.01).PGE2 levels were significantly negatively correlated with PPV,PVD,MFI,LVEF,FS measurements(P<0.05 or P<0.01).There is a significant negative correlation between HIF-1αand PPV,PVD,MFI,LVEF,CO,and FS measurements(P<0.01).Conclusion:Blood lactate,PGE2,and HIF-1αlevels in patients with sepsis complicated by acute heart failure can significantly increase and is closely related to the patient's heart function damage and microcirculation disorders.