摘要
目的分析趋化因子CX3C配体1(CX3CL1)和CX3C趋化因子受体1(CX3CR1)水平与慢性心力衰竭(CHF)患者心功能分级和预后的相关性。方法回顾性分析中国人民解放军东部战区总医院和武汉亚洲心脏病医院2021年6月至2023年6月200例CHF患者的临床资料,患者均接受心力衰竭标准化治疗。记录患者的基线临床资料;采用酶联免疫吸附法检测CX3CL1和CX3CR1水平;采用纽约心脏病协会(NYHA)心功能分级方法进行心功能分级。患者随访时间截至2023年12月,根据预后将患者分为预后不良组(全因死亡和心力衰竭再入院)和预后良好组。相关性分析采用Pearson法;采用多因素Logistic回归分析影响CHF患者预后不良的独立危险因素。结果200例患者中,NYHA心功能分级Ⅰ~Ⅱ级80例,Ⅲ~Ⅳ级120例。NYHA心功能分级Ⅲ~Ⅳ级患者CX3CL1和CX3CR1明显高于NYHA心功能分级Ⅰ~Ⅱ级患者[(3.34±0.45)mg/L比(2.45±0.26)mg/L和(8.71±0.92)mg/L比(2.53±0.35)mg/L],差异有统计学意义(t=15.99和57.34,P<0.01)。预后不良组(40例)年龄<60岁比例、合并冠心病率、CX3CL1、CX3CR1、体质量指数和超敏C反应蛋白明显高于预后良好组(160例)[82.50%(33/40)比10.62%(17/160)、90.00%(36/40)比68.12%(109/160)、(3.26±0.77)mg/L比(2.25±0.27)mg/L、(8.35±2.01)mg/L比(2.48±0.31)mg/L、(26.80±3.55)kg/m2比(24.74±2.76)kg/m2和(9.31±2.19)mg/L比(3.58±2.28)mg/L],吸烟史率和左心室射血分数明显低于预后良好组[37.50%(15/40)比46.88%(75/160)和(30.14±5.77)%比(59.40±6.58)%],差异有统计学意义(P<0.01)。Pearson相关分析结果显示,CX3CL1和CX3CR1与NYHA心功能分级呈正相关(r=0.29和0.34,P<0.05),与预后呈负相关(r=-0.54和-0.36,P<0.05)。多因素Logistic回归分析结果显示,CX3CL1和CX3CR1为影响CHF患者预后不良的独立危险因素(OR=2.110和1.566,95%CI 0.445~3.125和0.270~3.455,P<0.01)。结论CX3CL1和CX3CR1与CHF患者心功能分级密切相关,入院时可考虑结合此两项指标对患者进行
Objective To analyze the correlation between chemokine CX3C ligand 1(CX3CL1),CX3C chemokine receptor 1(CX3CR1)and heart function grade,prognosis in patients with chronic heart failure(CHF).Methods The clinical data of 200 patients with CHF from June 2021 to June 2023 in General Hospital of Eastern Theater of the Chinese People′s Liberation Army and Wuhan Asia Heart Hospital were retrospectively analyzed,and all patients received standardized treatment for heart failure.The baseline clinical data were recorded;the levels of CX3CL1 and CX3CR1 were detected by enzyme linked immunosorbent assay;the heart function grade was evaluated by New York Heart Association(NYHA)heart function grade method.The patients were followed up until December 2023,the patients were divided into poor prognosis group(all-cause death and readmission due to heart failure)and good prognosis group based on their prognosis.Pearson method was used for correlation analysis.Multivariate Logistic regression analysis was used to analyze the independent risk factors of poor prognosis in patients with CHF.Results Among the 200 patients,NYHA heart function gradeⅠtoⅡwas in 80 cases,ⅢtoⅣin 120 cases.The levels of CX3CL1 and CX3CR1 in patients with NYHA heart function gradeⅢtoⅣwere significantly higher than those in patients with NYHA heart function gradeⅠtoⅡ:(3.34±0.45)mg/L vs.(2.45±0.26)mg/L and(8.71±0.92)mg/L vs.(2.53±0.35)mg/L,and there were statistical differences(t=15.99 and 57.34,P<0.01).The proportion of age<60 years old,rate of coronary heart disease,CX3CL1,CX3CR1,body mass index and high-sensitivity C-reactive protein in poor prognosis group(40 cases)were significantly higher than those in good prognosis group(160 cases):82.50%(33/40)vs.10.62%(17/160),90.00%(36/40)vs.68.12%(109/160),(3.26±0.77)mg/L vs.(2.25±0.27)mg/L,(8.35±2.01)mg/L vs.(2.48±0.31)mg/L,(26.80±3.55)kg/m 2 vs.(24.74±2.76)kg/m 2 and(9.31±2.19)mg/L vs.(3.58±2.28)mg/L,the rate of smoking history and left ventricular ejection fraction were significantly lo
作者
杨春
吕磊
殷宇岗
陈琳
Yang Chun;Lyu Lei;Yin Yugang;Chen Lin(Second Cadre Department of Cardiology,General Hospital of Eastern Theater of the Chinese People′s Liberation Army,Nanjing 210002,China;Department of Cardiology,Wuhan Asia Heart Hospital,Wuhan 430002,China)
出处
《中国医师进修杂志》
2024年第9期780-785,共6页
Chinese Journal of Postgraduates of Medicine
基金
江苏省老年健康科研项目(LKZ2023011)
东部战区总医院院内课题(22JCYYYB47)。
