摘要
目的明确射血分数保留心力衰竭(HFpEF)患者胆汁酸代谢谱,探讨相关指标的变化及意义。方法收集2019年10月至2020年10月乌鲁木齐市友谊医院心内科收治的HFpEF患者223例进行回顾性分析。检测患者外周血脑利尿钠肽(BNP)、高敏C反应蛋白(hs-CRP)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、三酰甘油(TG)、总胆固醇(TC)、血糖(GLU)水平;采用高效液相色谱质谱法检测胆汁酸谱指标水平,并进行相关指标的对比分析。结果随着心功能分级的增加,HFpEF患者外周血BNP和LDL水平升高,HDL水平降低,且差异均有统计学意义(P<0.05);不同心功能分级HFpEF患者外周血甘氨鹅脱氧胆酸(GCDCA)、甘氨胆酸(GCA)、甘氨熊脱氧胆酸(GUDCA)、甘氨石胆酸(GLCA)、牛磺石胆酸(TLCA)水平不同,其中,TLCA水平随着心功能分级的增加而升高(P<0.001);与未合并稳定性冠心病、高血压、糖尿病的HFpEF患者相比,合并稳定性冠心病、高血压、糖尿病的HFpEF患者牛磺胆酸(TCA)、GCA、GCDCA水平均降低,牛磺脱氧胆酸(TDCA)、TLCA、GUDCA水平均升高,且差异均有统计学意义(P<0.05);Spearman相关分析结果显示,HFpEF患者GCDCA、UDCA、TLCA水平与心衰、血脂水平、血糖水平均相关(P<0.05)。结论HFpEF者胆汁酸谱具有一定特征,胆汁酸代谢可能参与HFpEF进程,TLCA未来有望成为疾病进展的新型标志物。
Objective To clarify the bile acid metabolism profile of patients with heart failure with preserved ejection fraction(HFpEF),and to analyze the changes and significance of related indicators.Methods We collected the peripheral blood of 223 patients with HFpEF from October 2019 to October 2020 in the Department of Cardiology of Urumqi Friendship Hospital,detected the levels of peripheral blood brain natriuretic peptide(BNP),high-sensitivity C-reactive protein(hs-CRP),low density lipoprotein(LDL),high density lipoprotein(HDL),triacylglycerol(TG),total cholesterol(TC),blood glucose(GLU).Ultra-high performance liquid chromatography-mass spectrometry was used to detect bile acid metabolism profiles,analyzed the related indicators.Results As the cardiac functional class of HFpEF patients increased,peripheral blood BNP and LDL levels increased and HDL levels decreased(P<0.05).Peripheral blood levels of glycingoodeoxycholic acid(GCDCA),glycincocholic acid(GCA),glycingoodeoxycholic acid(GUDCA),glycinolithocholic acid(GLCA),and taurocholic acid(TLCA)were different in patients with different cardiac function classes,and TLCA levels increased with cardiac function class(P<0.001).In patients with combined stable coronary artery disease,hypertension,and diabetes,taurocholic acid(TCA),GCA,and GCDCA levels were significantly lower than control,while taurodeoxycholic acid(TDCA),TLCA,and GUDCA levels were significantly higher than control,all with statistically significant differences(P<0.05).Correlation analysis revealed that GCDCA,UDCA,and TLCA were associated with heart failure,lipid,and glucose levels(P<0.05).Conclusion The bile acid profile has certain characteristics in HFpEF,and bile acid metabolism may be involved in the HFpEF process and TLCA is expected to be a novel marker of progression.
作者
罗先道
张朝新
王欢
朱霞
曾祥琴
菲尔达吾斯·萨依然
郭淑丽
LUO Xiandao;ZHANG Chaoxin;WANG Huan;ZHU Xia;ZENG Xiangqin;FEIERDAWUSI·Sayiran;Guo Shuli(Department of Cardiology,Urumqi Friendship Hospital,Urumqi 830049;Clinical Laboratory Center of People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001;Hangzhou Normal University,Hangzhou 311100,China)
出处
《中国分子心脏病学杂志》
CAS
2023年第1期5156-5161,共6页
Molecular Cardiology of China
基金
新疆维吾尔自治区自然科学基金(2020D01A30)。
关键词
心力衰竭
射血分数
胆汁酸
代谢谱
冠心病
Heart failure
Ejection fraction
Bile acid
Metabolic profile
Coronary heart disease
