吸烟对左室射血分数正常心衰患者静息能量消耗影响.docVIP

吸烟对左室射血分数正常心衰患者静息能量消耗影响 　　【摘要】 目的：观察吸烟对左室射血分数正常心衰患者静息能量消耗（REE）的影响及与氧化应激和炎症反应之间的关系。方法：对41例吸烟和40例非吸烟的左室射血分数正常心衰患者的一般情况、临床特征、REE、REE与去脂组织（FFM）的比值、氧化应激及炎症反应标志物进行比较分析。结果：吸烟组的REE/FFM比非吸烟组显著增高16.78%，相关分析提示，REE/FFM的增高与吸烟有关（r=0.413，P=0.002）。两组的氧化应激标志物丙二醛（MDA）、超氧化物歧化酶（SOD）、炎症反应标志物高敏C反应蛋白（hs-CRP）、脂联素和TNF-α比较差异均有统计学意义（P0.05），REE/FFM的增高与MDA、SOD、hs-CRP、脂联素、TNF-α均相关（P0.05）。结论：吸烟可导致左室射血分数正常心衰患者REE增加，引起氧化应激和炎症反应。 　　【关键词】 吸烟； 左室射血分数： 心衰； 能量代谢 　　【Abstract】 Objective：To study the effect of smoking on resting energy expenditure（REE） and the relationships among REE，smoking，inflammation and oxidative stress in patients with heart failure and normal left ventricular ejection fraction.Method：41 smokers and 40 non-smokers with heart failure and normal left ventricular ejection fraction were performed to evaluate the chronic effect of smoking on REE，REE/fat free mass（FFM），biomarkers of oxidative stress malondialdehyde （MDA），superoxidedismutase（SOD），inflammation high-sensitivity C-reactive protein （hs-CRP） and adiponectin，the data of them were analyzed by Pearson correlation analysis.Result：Compared with non-smokers， REE/FFM in smokers group was significantly increased by 16.78%（P=0.001），Pearson analysis showed that smoking was significantly correlated with REE/FFM（r=0.413，P=0.002）.There were significantly differences between smokers and non-smokers in MDA，SOD，adiponectin，TNF-α and hs-CRP（P0.05）.Significant relationships between REE/FFM and MDA，SOD，hs-CRP，adiponectin，TNF-α were found（P0.05）.Conclusion：Chronic smoking can lead to increased REE，arouse oxidative stress and inflammatory in patients with heart failure and normal left ventricular ejection fraction. 　　【Key words】 Smoking； Left ventricular ejection fraction； Heart failure； Energy metabolism 　　First-author’s address：Traditional Chinese Medicine Hospital of Gaomi City，Gaomi 261500，China 　　doi：10.3969/j.issn.1674-4985.2015.32.019 　　左室射血分数正常心衰患者是临床上最常见的心衰，任何增加心脏负荷的因素，均有可能会加重心衰发展。心率是临床心血管事件发生的主要危险因素，心率的变异性是衡量心脏功能的重要标志，在影响心肌能量消耗的诸多因