入院时静息心率与慢性心力衰竭患者血清炎性因子及脑钠肽的关系

摘要
图/表
参考文献(23)
相关文章 (15)

全文: PDF (367 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨入院时静息心率与慢性心力衰竭（CHF）患者血清炎性因子及脑钠肽（BNP）的关系。方法选取2013年5月～2018年2月于首都医科大学附属北京地坛医院就诊的153例CHF患者作为研究对象。按照患者入院时静息心率的不同将其分为A、B、C三组，静息心率≤70次/min为A组共46例，＞70～＜90次/min为B组共52例，≥90次/min为C组共55例。患者于入院休息1 h后在静息条件下检测静息心率，测量左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）和左室射血分数（LVEF）。于入院次日采集空腹静脉血，取血清测定C-反应蛋白（CRP）、BNP、白细胞介素（IL）-1β、IL-6及肿瘤坏死因子（TNF）-α含量。并将入院时静息心率与患者血清炎性因子和BNP进行Pearson相关性分析。结果 C组CRP、BNP、IL-1β、IL-6及TNF-α含量均显著高于A、B两组（P < 0.05），且B组上述各指标含量均显著高于A组（P < 0.05）。C组LVEDD及LVESD均显著长于A、B两组，LVEF显著低于A、B两组（P < 0.05）；B组LVEDD及LVESD均显著长于A组，LVEF显著低于A组（P < 0.05）。C组NYHA心功能Ⅱ级例数显著少于A、B两组，NYHA心功能Ⅲ/Ⅳ级例数均显著多于A、B两组（P < 0.05）。CHF患者入院时静息心率与CRP、BNP、IL-1β、IL-6、TNF-α、LVEDD及LVESD呈正相关（r = 0.350、0.584、0.305、0.411、0.349、0.334、0.395，均P < 0.05），与LVEF呈负相关（r = -0.425，P < 0.05）。结论入院时静息心率水平与CHF患者CRP、IL-1β、IL-6及TNF-α炎性因子和血清BNP含量呈正相关关系，且与心功能存在相关性。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	吕雪雅刘海燕郑迪韩晓涛董茜

关键词 ：静息心率, 慢性心力衰竭, 炎性因子, 脑钠肽

Abstract：Objective To investigate relationship between resting heart rate at admission and serum inflammatory factors and brain natriuretic peptide (BNP) in patients with chronic heart failure (CHF). Methods One hundred and fifty-three cases of CHF treated in Beijing Ditan Hospital, Capital Medical University from May 2013 to February 2018 were selected as subjects of study. According to the different resting heart rates at admission, patients were divided into three groups: group A, group B and group C. Group A (resting heart rate ≤70 beats/min) was 46 cases, group B (resting heart rate ＞70-＜90 beats/min) was 52 cases and group C (resting heart rate ≥90 beats/min) was 55 cases. The resting heart rate, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were measured under resting condition after the patients were admitted and had 1 hour rest. Fasting venous blood was collected on the next day after admission. Serum levels of C-reactive protein (CRP), BNP, interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α were measured. Pearson correlation between resting heart rate at admission and serum inflammatory factors and BNP in patients was analyzed. Results The contents of CRP, BNP, IL-1β, IL-6 and TNF-α in group C were significantly higher than those in group A and B (P < 0.05), and the contents of the above indexes in group B were significantly higher than those in group A (P < 0.05). LVEDD and LVESD in group C were significantly longer than those in group A and B, and LVEF in group C was significantly lower than those in group A and B (P < 0.05); LVEDD and LVESD in group B were significantly longer than those in group A, and LVEF in group B was significantly lower than that in group A (P < 0.05). The number of NYHA class Ⅱ cases in group C was significantly less than that in group A and B, and the number of NYHA class Ⅲ/Ⅳ cases in group C was significantly more than those in group A and B (P < 0.05). Resting heart rate of CHF patients at admission was positively correlated with CRP, BNP, IL-1β, IL-6, TNF-α, LVEDD and LVESD (r = 0.350, 0.584, 0.305, 0.411, 0.349, 0.334, 0.395, all P < 0.05), and resting heart rate of CHF patients at admission was negatively correlated with LVEF (r = -0.425, P < 0.05). Conclusion The resting heart rate at admission is positively correlated with CRP, IL-1β, IL-6, TNF-α inflammatory factors and serum BNP levels in CHF patients, and is correlated with cardiac function.

Key words： Resting heart rate Chronic heart failure Inflammatory factor Brain natriuretic peptide

基金资助:北京市科技计划项目（Z151100004015237）。

通讯作者: 董茜（1973.9-），女，副主任医师；研究方向：冠心病复杂冠状动脉病变预后临床分析。

作者简介: 吕雪雅（1991.1-），女，硕士；研究方向：冠心病合并甲状腺功能异常的临床分析。

引用本文:

吕雪雅刘海燕郑迪韩晓涛董茜. 入院时静息心率与慢性心力衰竭患者血清炎性因子及脑钠肽的关系[J]. 中国医药导报, 2019, 16(26): 70-73.
LV Xueya LIU Haiyan ZHENG Di HAN Xiaotao DONG Xi. Relationship between resting heart rate at admission and serum inflammatory factors and brain natriuretic peptide in patients with chronic heart failure. 中国医药导报, 2019, 16(26): 70-73.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I26/70

[1] 黎励文，李明敏.慢性心力衰竭的治疗进展[J].中华老年心脑血管病杂志，2016，18（7）：673-675.
[2] Hopper I，Easton K. Chronic heart failure [J]. Aust Prescr，2017，40（4）：128-136.
[3] 陈伟伟，王文，隋辉，等.《中国心血管病报告2016》要点解读[J].中华高血压杂志，2017，32（7）：605-608.
[4] B?觟hm M，Reil JC，Deedwania P，et al. Resting heart rate：risk indicator and emerging risk factor in cardiovascular disease [J]. Am J Med，2015，128（3）：219-228.
[5] 邹甜甜，费安兴，高淑珍，等.心力衰竭伴肺部感染患者炎性因子、N端脑钠肽前体的水平变化及临床意义[J].河北医药，2018，40（3）：329-331，336.
[6] Olsson LG，Swedberg K，Cleland JG，et al. Prognostic importance of plasma NT-pro BNP in chronic heart failure in patients treated with a beta-blocker：results from the Carvedilol or Metoprolol European Trial（COMET） [J]. Eur J Heart Fail，2014，9（8）：795-801.
[7] 田朝伟，陈晓辉.急性心力衰竭的诊治进展：2016 ESC急慢性心力衰竭诊断和治疗指南[J].中华急诊医学杂志，2016，25（7）：854-857.
[8] 邱伯雍，王永霞.慢性心力衰竭流行病学及防治研究进展[J].中华实用诊断与治疗杂志，2017，31（6）：619-621.
[9] 孙传学，崔艳艳，孙桂芳.乌头赤石脂汤联合西医常规疗法治疗缺血性心肌病伴心力衰竭[J].国际中医中药杂志，2018，40（10）：908-912.
[10] 李文安，郭镇声，李丽霞，等.血浆BNP对不同类型老年心力衰竭预测急性失代偿心衰的价值[J].中国现代医生，2017，55（14）：22-24.
[11] 陈光.伊伐布雷定治疗老年心力衰竭患者的疗效观察[J].中国医药科学，2017，7（17）：82-84.
[12] 吴扬燕，罗向卫，崔跃，等.心脏彩超左室射血分数与老年多病因心力衰竭的临床研究[J].中国医药科学，2018， 8（3）：164-166.
[13] 畅晓园，鹿育萨，杨济民，等.正常血压人群静息心率与心血管病危险因素的相关性研究[J].中华高血压杂志，2016，24（8）：800.
[14] 施继红，季春鹏，朱辰蕊，等.收缩压和静息心率与新发糖尿病的关系[J].中华高血压杂志，2017，25（10）：968-973.
[15] 金德奎，於四军，王文启，等.静息心率与慢性心力衰竭患者血清NT-proBNP的相关性分析[J].现代生物医学进展，2016，16（18）：3519-3522.
[16] 王晓丽，王文棣，郑兴厂.静息心率与血管内皮功能[J].心血管病学进展，2016，37（3）：308-310.
[17] Serruys PW，Chevalier B，Dudek D，et al. A bioresorbable everolimus-eluting scaffold versus a metallic everolimus-eluting stent for ischaemic heart disease caused by de-novo native coronary artery lesions（ABSORB Ⅱ）：an interim 1-year analysis of clinical and procedural secondary outcomes from a randomised controlled trial [J]. Lancet，2015，385（9962）：43-54.
[18] 李强.静息心率：疾病的风险指标和危险因素[J].临床心身疾病杂志，2016，22（1）：31-32.
[19] Pasini E，Aquilani R，Testa C，et al. Pathogenic gut flora in patients with chronic heart failure [J]. JACC Heart Fail，2016，4（3）：220-227.
[20] 王琴.血浆高敏C反应蛋白和B型脑钠肽检测在老年慢性心力衰竭患者院内恶性室性心律失常中的应用价值[J].临床合理用药杂志，2017，10（36）：123-124.
[21] 马柳一，尹玉洁，李红蓉，等.慢性心力衰竭患者交感神经激活的中枢机制及治疗进展[J].中国老年学杂志，2016，36（12）：3068-3071.
[22] 胡华平，郭冠军，张苏明，等.老年患者心率变异性与血压曲线类型及心室重构的关系[J].安徽医学，2017，38（8）：1065-1067.
[23] Hill LBK，Hu DD，Koenig J，et al. Ethnic differences in resting heart rate variability：a systematic review and meta-analysis [J]. Psychosom med，2015，77（1）：16-25.