【摘要】 目的探讨红细胞膜脂肪酸与慢性心力衰竭(CHF)的相关性。方法利用气相色谱质谱仪检测2019年5月至2020年4月该院收治的308例CHF患者和100例体检健康者的红细胞脂肪酸水平,按照美国纽约心脏病协会(NYHA)分级标准,CHF患者分为Ⅱ级组101例、Ⅲ级组107例、Ⅳ级组100例,对比健康人群与不同分期慢性心力衰竭患者之间红细胞脂肪酸、Omega-3指数水平,并分析其与CHF的相关性。结果不同分期的CHF患者的二十碳五烯酸(EPA)、二十二碳六烯酸(DHA)、花生四烯酸(AA)、油酸水平有显著差异,其EPA、DHA水平均随着CHF程度的增加而降低,且均明显低于对照组;而AA、油酸水平均随着CHF程度的增加而升高,且均明显高于对照组,差异均有统计学意义(均P<0.05)。但对照组与不同分期之间的CHF患者的月桂酸、亚油酸、软脂酸及硬脂酸水平比较差异无统计学意义(P>0.05)。各组的单不饱和脂肪酸(MUFA)、Omega-3脂肪酸、Omega-6脂肪酸水平、Omega-3指数差异均有统计学意义(P<0.05),但各组间的饱和脂肪酸(SFA)水平差异无统计学意义(P>0.05)。Spearman相关性分析表明,CHF分级与EPA、DHA、Omega-3脂肪酸、Omega-3指数呈负相关关系,与AA、油酸、Omega-6脂肪酸呈正相关关系(P<0.01)。结论 EPA、DHA、Omega-3脂肪酸及Omega-3指数在CHF患者红细胞膜中表达降低,而AA、油酸、Omega-6脂肪酸及MUFA表达升高;且Omega-3脂肪酸、Omega-3指数与CHF的发生发展有关,其低表达可能预示CHF程度增高。更多还原

【Abstract】 Objective To investigate the pertinence between erythrocyte membrane fatty acids and chronic heart failure(CHF).Methods Three hundred and eight patients with CHF who were admitted to the Guangzhou First People′s Hospital from May 2019 to April 2020 were selected and divided into grade Ⅱ group(n=101),grade Ⅲ group(n=107),and grade Ⅳ group(n=100) according to the NYHA grading standard, and another 100 healthy people who underwent physical examination in the Guangzhou First People′s Hospital during the same period were selected as control group.The levels of erythrocyte membrane fatty acid and Omega-3 index measured by gas chromatography-mass spectrometer were compared among each group, and their pertinence with CHF was analyzed.Results The levels of EPA,DHA,AA and oleic acid in CHF patients at different stages were obviously different, which the levels of EPA and DHA decreased with the increase of CHF degree, and were distinctly lower than those in control group, while the levels of AA and oleic acid increased with the increase of CHF,and were visibly higher than those of the control group, and the differences were statistically significant(P<0.05).However, there was no striking difference in the levels of lauric acid, linoleic acid, palmitic acid and stearic acid between the control group and CHF patients with varied stages, the difference was not statistically significant(P>0.05).The levels of MUFA,Omega-3 fatty acids, Omega-6 fatty acids and Omega-3 index were observably different in each group, and the differences were statistically significant(P<0.05),but there was no prominent difference in the levels of SFA in each group, and the difference was not statistically significant(P>0.05).Spearman correlation analysis showed that the CHF was negatively correlated with EPA,DHA,Omega-3 fatty acid and Omega-3 index, while positively correlated with AA,oleic acid and Omega-6 fatty acids(P<0.01).Conclusion The expression of EPA,DHA,Omega-3 fatty acid and Omega-3 index in the erythrocyte membrane of CHF patients decreased, while the expression of AA,oleic acid, Omega-6 fatty acid and MUFA increased; Omega-3 fatty acid and Omega-3 index are related to the occurrence and development of CHF,and their low expression may indicate the increased degree of CHF.更多还原