血清游离脂肪酸与急性心力衰竭患者心功能的相关性

doi:10.3969/j.issn.1004-583X.2021.03.003

摘要/Abstract

摘要：

目的探究血清游离脂肪酸(FFA)与急性心力衰竭(AHF)患者心功能的相关性。方法将163例AHF患者依左心室射血分数(LVEF)分为LVEF<40%组及LVEF≥50%组。检测患者入院时FFA、N末端前体脑利钠肽(NT-proBNP)、心肌肌钙蛋白I(cTnI)等相关指标,行心脏彩色超声检查监测LVEF、左心室短轴缩短率(FS)、左心室舒张末内径(LVEDD)以及左心室收缩末内径(LVESD)、心肌做功指数(TEi指数)等指标。结果 LVEF<40%组FFA、NT-proBNP、cTnI明显高于LVEF≥50%组(P<0.05)。FFA、NT-proBNP、cTnI是AHF患者LVEF<40%发生的危险因素。FFA、NT-proBNP预测AHF患者LVEF<40%发生的AUC分别为0.856、0.810。在AHF患者中高FFA组较低FFA组患者的心功能明显降低(P<0.05)。结论 FFA、NT-proBNP、cTnI是AHF患者LVEF<40%发生的危险因素,其中FFA对于患者心功能的恶化具有一定的预测价值。

关键词: 心力衰竭, 脂肪酸类, 左心室射血分数

Abstract:

Objective To explore the correlations between serum free fatty acid(FFA) and cardiac function in patients with acute heart failure(AHF). Methods One hundred and sity three patients with AHF were divided into the LVEF<40% group and LVEF≥50% group basics on left ventricular ejection fraction(LVEF). FFA, N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I(cTnI)and other related indicators were detected when admission. Indicators including the left ventricular ejection fraction(LVEF), LVEF fraction shortening(FS), left ventricular end-diastolic diameter(LVEDD), eft ventricular end-systolic dimension(LVESD) and TEi index were recorded. Results FFA, NT-proBNP and cTnI in LVEF<40% group was significantly higher than such indexes in LVEF≥50% group (P<0.05). FFA, NT-proBNP and cTnI were risk factors for LVEF<40% in AHF patients. The predicted AUC of FFA and NT-proBNP for patients with LVEF<40% were 0.856 and 0.810 respectively. In AHF patients, the cardiac function of high FFA group was significantly lower than that of low FFA group (P<0.05). Conclusion FFA, NT-proBNP and cTnI are the risk factors of LVEF < 40% in patients with AHF. FFA has certain predictive value for predicting the deterioration of patients' heart function among of these.

Key words: heart failure, fatty acid, left ventricular ejection fraction

中图分类号:

R541.6

柏莲, 郭鹏, 栾波, 白浩, 江珊. 血清游离脂肪酸与急性心力衰竭患者心功能的相关性[J]. 临床荟萃, 2021, 36(3): 208-211.

Bai Lian, Guo Peng, Luan Bo, Bai Hao, Jiang Shan. Correlation between serum free fatty acid and cardiac function in patients with acute heart failure[J]. Clinical Focus, 2021, 36(3): 208-211.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.03.003

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I3/208

图/表 5

参考文献 19

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组别	例数	性别(例)		年龄 (岁)	BMI (kg/m²)	病史(例)
组别	例数	男	女	年龄 (岁)	BMI (kg/m²)	吸烟史	饮酒史	糖尿病	高血压	房颤史	心肌梗死史	PCI术后
LVEFF<40%组	83	55	28	69.1±4.65	23.73±3.07	36	33	37	32	37	32	25
LVEF≥50%组	80	42	38	68.8±4.42	24.52±4.05	36	39	39	33	27	26	20
统计值		χ²=0.042		t=0.095	t=1.090	χ²=0.174	χ²=0.346	χ²=0.932	χ²=0.673	χ²=0.172	χ²=0.642	χ²=0.163
P值		0.13		0.49	0.06	0.96	0.34	0.82	0.88	0.35	0.46	0.68

组别	例数	性别(例)		年龄 (岁)	BMI (kg/m²)	病史(例)
组别	例数	男	女	年龄 (岁)	BMI (kg/m²)	吸烟史	饮酒史	糖尿病	高血压	房颤史	心肌梗死史	PCI术后
LVEFF<40%组	83	55	28	69.1±4.65	23.73±3.07	36	33	37	32	37	32	25
LVEF≥50%组	80	42	38	68.8±4.42	24.52±4.05	36	39	39	33	27	26	20
统计值		χ²=0.042		t=0.095	t=1.090	χ²=0.174	χ²=0.346	χ²=0.932	χ²=0.673	χ²=0.172	χ²=0.642	χ²=0.163
P值		0.13		0.49	0.06	0.96	0.34	0.82	0.88	0.35	0.46	0.68

组别	例数	cTnI(ng/ml)	Scr(μmol/L)	TG(mmol/L)	FFA(μmol/L)	NT-proBNP(pg/ml)
LVEFF<40%组	83	0.22(0.58)	87.00(66.90)	1.46(0.90)	666.27(219.48)	4267.00(3444.00)
LVEF≥50%组	80	0.14(0.39)	127.00(98.65)	1.38(0.64)	454.96(124.63)	2916.00(1317.50)
Z值		2.221	1.720	0.252	7.854	7.878
P值		0.026	0.086	0.801	0.000	0.000

组别	例数	cTnI(ng/ml)	Scr(μmol/L)	TG(mmol/L)	FFA(μmol/L)	NT-proBNP(pg/ml)
LVEFF<40%组	83	0.22(0.58)	87.00(66.90)	1.46(0.90)	666.27(219.48)	4267.00(3444.00)
LVEF≥50%组	80	0.14(0.39)	127.00(98.65)	1.38(0.64)	454.96(124.63)	2916.00(1317.50)
Z值		2.221	1.720	0.252	7.854	7.878
P值		0.026	0.086	0.801	0.000	0.000

变量	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
变量	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
CTnI(ng/ml)	1.065	0.443	5.768	0.016	2.901	1.216	6.918
FFA(μmol/L)	0.005	0.002	7.206	0.007	1.006	1.001	1.010
NT-proBNP(pg/ml)	0.001	0.000	12.878	0.000	1.001	1.001	1.002
常量	-7.239	1.214	33.546	0.000	0.001