冠心病合并心力衰竭患者血清HO-1/CO系统水平变化及其意义

目的 通过比较冠心痛所致慢性心力衰竭患者及冠心痛心功能正常患者血清血红素加氧酶-1(HO-1)及一氧化碳(CO)水平差异,进一步探讨HO-1/CO系统在慢性心力衰竭发病中的保护机制.方法 选择慢性心力衰竭患者91例作为观察组,以72例冠心病心功能正常患者作为对照组,采用双抗体酶联免疫吸附(ELISA)测定HO-1浓度,Chalmer S法检测血清CO浓度;通过心力衰竭调查表记录入两组病例一般临床资料,并进行肝肾功能、血脂、NT-proBNP、BNP及心脏超声心动图等检查.结果 观察组血清HO-1水平(8.13±0.27) ng/mL高于对照组(2.80±0.52)ng/mL;观察组CO水平(0.35±0.06)mg/L低于对照组(0.59±0.07) mg/L,差异均有统计学意义(P＜0.01);观察组HO-1水平随心功能分级增高而逐渐增高(P＜0.01),而CO水平随心功能分级增高而逐渐降低(P＜0.01).结论 慢性心力衰竭患者随着心力衰竭加重血清HO-1水平高表达,内源性CO因心力衰竭加重后消耗而逐渐降低.

Change and significance of serum HO-1/CO system level in patients with coronary heart disease complicating heart failure

Objective To compare the difference of serum heme oxygenase-1 (HO-1) and carbon monoxide(CO) levels between the patients with coronary heart disease(CHD) caused chronic heart failure(CHF) and CHD patients with normal cardiac function,and further to explore the protective mechanism of HO-1/CO system during the pathogenesis process of CHF.Methods Ninety-one patients with CHF were selected as the observation group and 72 CHD cases with normal cardiac function were taken as the control group.The concentration of HO-1 was determined by ELISA arid the Chalmer S method was used to detect serum CO concentration.The general clinical data of the two groups were recorded by the using the heart failure questionnaire.And the liver and kidney functions,blood lipids,NT-proBNP,BNP and cardiac echocardiography examination were performed.Results The serum HO-1 level in the observation group was (8.13±0.27)ng/mL,which was higher than (2.80±0.52)ng/mL in the control group;the CO level in the observation group was (0.35±0.06)mg/L,which was lower than(0.59±0.07)mg/L in the control group,the difference was statistically significant(P＜0.01);the HO-1 level in the observation group was gradually increased with the increase of cardiac function grade (P＜0.01);while the CO level was decreased with the increase of cardiac function grade (P＜0.01).Conclusion The serum HO-11evel in the patients with CHF is highly expressed with the heart failure aggravation;endogenous CO is gradually decreased due to consumption after cardiac failure aggravation.