老年慢性心衰患者血清胆汁酸水平与炎症因子及 心室重构的关系

目的 分析老年慢性心力衰竭（CHF）患者血清总胆汁酸（BA）水平与炎症因子及心室重构的关系。方 法 82 例 CHF 患者按照 NYHA 心功能分级标准分为 NYHA Ⅱ级（CHF Ⅱ级组）47 例，Ⅲ级（CHF Ⅲ级组）35 例，另 选取无心衰症状，且超声心动图及血清 B 型钠尿肽前体（pro-BNP）未见异常的同期体检者 32 例作为对照组。应用 酶比色法检测所有入选者血清 BA 水平，放射免疫法检测白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平。行 超声心动图检查，测量左室舒张末期内径（LVEDD），并应用 Simpson 法计算左室射血分数（LVEF）。结果 3 组间 IL-6、TNF-α、BA、pro-BNP、LVEDD、LVEF 水平差异均有统计学意义。CHF 组 IL-6、TNF-α、BA、proBNP、LVEDD 水 平均高于对照组，且随着心功能分级增加而升高；而 LVEF 低于对照组，且随着心功能分级增加而降低（均 P＜ 0.05）。BA 与 IL-6、TNF-α、pro-BNP、LVEDD 呈正相关，与 LVEF 呈负相关（均 P＜0.05）。结论 血清 BA 水平与机 体炎症反应及心室重构相关，对于评估 CHF 患者心功能状况具有一定的参考价值。

Correlation of serum bile acid concentration with inflammatory cytokines and ventricular remodel in elderly patients with chronic heart failure

Objective To investigate the correlation of serum total bile acid (BA) with inflammatory cytokines and ventricular remodeling in elderly patients with chronic heart failure (CHF). Methods A total of 82 patients with CHF were divided into mild group (NYHA grade Ⅱ, n=47) and moderate group (NYHA grade Ⅲ, n=35), according to the grade of cardiac function. A total of 32 subjects with normal physical examination during the same period were selected as the control group. Serum levels of BA, IL-6, TNF-α, pro-BNP, LVEDD and LVEF were measured respectively. Results There were significant differences in IL-6, TNF-α, BA, pro-BNP, LVEDD and LVEF between the three groups (all P＜0.05), which were significantly higher in CHF group than those of control group, and which were increased with the increase of cardiac function grade (P＜0.05). The value of LVEF was significantly lower in CHF group than that of control group, and which was decreased with the increase of cardiac function grade (P＜0.05). There were positive correlations between BA, IL-6, TNF-α, pro-BNP and LVEDD (P＜0.05). There was a negative correlation between BA and LVEF (P＜0.05). Conclusion Serum BA level is correlated with inflammation and ventricular remodel, and which has a certain reference value for the evaluation of cardiac function in elderly patients with CHF．