| 谢学建,谢晓莉,殷 忠,侯云飞,张巧宁,张学军.心力衰竭患者血清中内源性Apela、NT-proBNP、IL-6水平与心室重塑、心脏储备功能的相关性[J].,2022,(13):2514-2518 |
| 心力衰竭患者血清中内源性Apela、NT-proBNP、IL-6水平与心室重塑、心脏储备功能的相关性 |
| Correlation of Endogenous Apela, NT-proBNP, IL-6 Levels in Serum with Ventricular Remodeling and Cardiac Reserve Function in Patients with Heart Failure |
| 投稿时间：2021-11-07 修订日期：2021-11-30 |
| DOI：10.13241/j.cnki.pmb.2022.13.022 |
| 中文关键词: 急性心肌梗死 心脏衰竭 内源性Apela 白细胞介素-6 N端脑钠肽前体 |
| 英文关键词: Acute myocardial infarction Heart failure Endogenous Apela Interleukin-6 N-terminal pro-brain natriuretic peptide |
| 基金项目:陕西省社会发展科技攻关项目（2015SF060） |
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| 中文摘要: |
| 摘要 目的：考察心力衰竭患者血清中内源性Apela、N端脑钠肽前体（NT-proBNP）、白细胞介素-6（IL-6）水平与心室重塑、心脏储备功能的相关性。方法：选取2018年5月至2021年5月，120例急性心肌梗死（AMI）后心力衰竭患者纳入研究。参与者被分为两组：心室重构组（n=51）和非心室重构组（n=69），另选取同期体检的47名健康受试者作为对照。除了左心室壁厚度（LVWT）和左心室质量指数（LVMI）外，还测量了血清内源性Apela、NT-proBNP和IL-6表达水平。分析血清内源性Apela、NT-proBNP和IL-6与LVWT、LVMI的相关性，评价其预测心室重构的价值。采用6MWT值、D/S值和ΔWMSI评估心脏储备功能。结果：三组左心室壁厚度（LVWT）和LVMI具有差异（P<0.05）；与对照组相比，心室重塑组和非心室重塑组血清内源性Apela水平较低，而IL-6和NT-proBNP水平较高。心室重塑组Apela水平低于非心室重塑组，而IL-6和NT-proBNP水平高于非心室重塑组。三组间血清内源性Apela、IL-6、NT-proBNP水平有差异（P<0.05）；在AMI后心力衰竭患者中，血清内源性Apela与LVWT和LVMI呈显著负相关（r=-0.485，-0.428；P=0.001，0.007）。此外，血清IL-6、NT-proBNP与LVWT和LVMI呈显著正相关（r=0.512，0.426；P=0.000，0.000）（r=0.592，0.530；P=0.000，0.000）；在AMI后心力衰竭患者中，血清内源性Apela水平与6WMD和D/S呈显著负相关（r=-0.659，-0.561；P=0.001，0.001）。此外，血清IL-6水平、NT-proBNP水平与6WMD和D/S呈显著正相关（r=0.203，0.381；P=0.000，0.000）（r=0.521，0.481；P=0.000, 0.000）；Logistic回归分析显示，血清Apela水平越低，血清IL-6和NT-proBNP水平越高，心室重塑的可能性越大。因此，血清内源性Apela、IL-6、NT-proBNP和Killip分级是心室重塑的危险因素。结论：早期联合检测血清内源性Apela、IL-6和 NT-proBNP水平可提高预测心室重塑的准确性，有助于AMI后心力衰竭的早期防治。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the correlation between the levels of endogenous Apela, NT-proBNP and IL-6 in the serum of patients with heart failure and ventricular remodeling and cardiac reserve function. Methods: From May 2018 to May 2021, 120 patients with heart failure after AMI were enrolled in the study. Participants were divided into two groups: ventricular remodeling group (n=51) and non-ventricular remodeling group (n=69). In addition, 47 healthy subjects who received physical examination during the same period were selected as controls. In addition to left ventricular wall thickness (LVWT) and left ventricular mass index (LVMI), serum endogenous Apela, NT-proBNP and IL-6 expression levels were also measured. Analyze the correlation between serum endogenous Apela, NT-proBNP and IL-6 with LVWT and LVMI, and evaluate their value in predicting ventricular remodeling. Use 6MWT value, D/S value and ΔWMSI to assess cardiac reserve function. Results: The left ventricular wall thickness (LVWT) and LVMI were different among the three groups(P<0.05); Compared with the control group, serum endogenous Apela levels were lower in the ventricular remodeling group and non-ventricular remodeling group, while IL-6 and NT-probNP levels were higher. The levels of Apela in the ventricular remodeling group were lower than those in the non-ventricular remodeling group, while the levels of IL-6 and NT-probNP were higher than those in the non-ventricular remodeling group. There were differences in serum endogenous Apela, IL-6 and NT-probNP levels among the three groups(P<0.05); In patients with heart failure after AMI, serum endogenous Apela was negatively correlated with LVWT and LVMI(r=-0.485, -0.428; P=0.001, 0.007). In addition, serum IL-6 and NT-probNP were significantly positively correlated with LVWT and LVMI(r=0.512, 0.426; P=0.000, 0.000)(r=0.592, 0.530; P=0.000, 0.000); Logistic regression analysis showed that the lower the serum Apela level, the higher the serum IL-6 and NT-probNP levels, the greater the possibility of ventricular remodeling. Therefore, serum endogenous Apela, IL-6, NT-probNP and Killip grading are risk factors for ventricular remodeling. Conclusion: Early combined detection of serum endogenous Apela, IL-6 and NT-probNP levels can improve the accuracy of predicting ventricular remodeling and contribute to the early prevention and treatment of heart failure after AMI. |
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