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中华卫生应急电子杂志 ›› 2022, Vol. 08 ›› Issue (03) : 134 -140. doi: 10.3877/cma.j.issn.2095-9133.2022.03.002

论著

Takotsubo综合征患者系统氧化应激与心脏功能相关性研究
祁春雷1, 翁川晴1, 刘念念1, 王信淳1, 苏俊伟1, 肖平喜1,()   
  1. 1. 210031 江苏南京,南京医科大学第四附属医院心血管内科
  • 收稿日期:2022-01-18 出版日期:2022-06-18
  • 通信作者: 肖平喜

Correlation between systemic oxidative stress and cardiac function in patients with Takotsubo syndrome

Chunlei Qi1, Chuanqing Weng1, Niannian Liu1, Xinchun Wang1, Junwei Su1, Pingxi Xiao1,()   

  1. 1. Department of Cardiology, the Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China
  • Received:2022-01-18 Published:2022-06-18
  • Corresponding author: Pingxi Xiao
引用本文:

祁春雷, 翁川晴, 刘念念, 王信淳, 苏俊伟, 肖平喜. Takotsubo综合征患者系统氧化应激与心脏功能相关性研究[J]. 中华卫生应急电子杂志, 2022, 08(03): 134-140.

Chunlei Qi, Chuanqing Weng, Niannian Liu, Xinchun Wang, Junwei Su, Pingxi Xiao. Correlation between systemic oxidative stress and cardiac function in patients with Takotsubo syndrome[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2022, 08(03): 134-140.

目的

Takotsubo综合征(TS)是一种病理机制非常复杂的心脏急症,其症状与急性冠脉综合征(ACS)相似,容易被误诊。TS人群预后不良,短期病死率与急性心肌梗死(AMI)患者相似,长期主要心血管事件发生率与ACS患者相当。本研究通过临床研究探索系统氧化应激与TS的相关性。

方法

收集临床以TS为第一诊断的住院患者共计12例,同时纳入条件匹配的AMI者和健康体检者为对照,记录人口学资料,使用床边超声评估三组人群心脏功能,通过检测血浆MDA水平和炎症因子浓度比较系统炎症水平。

结果

与AMI人群和健康对照人群相比较,TS患者心脏功能明显下降,血浆MDA浓度增高,炎症细胞水平上调和炎症因子分泌增多。

结论

TS患者系统氧化应激水平增高和炎症反应激活。

Objective

Takotsubo syndrome(TS)is classed as a kind of acute cardiac syndrome with a high incidence of major cardiac events. TS is easy to be misdiagnosed due to the initial clinical presentation and laboratory examination which are similar to acute coronary syndrome(ACS). This study aimed to explore the relationship between systemic oxidative stress and TS through clinical research.

Methods

A total of 12 inpatients with TS as the first diagnosis were collected, while AMI patients and the healthy people examined with matching conditions were both included in the controls. Demographic data were recorded, as well as cardiac function was evaluated by ultrasound.At the same time, we detected the levels of plasma MDA and inflammatory factors in the three groups.

Results

It was found out in clinical trials that the production of plasma MDA in TS patients showed a significant increase.In the meantime, the level of inflammatory cells and the inflammatory factors were elevated.

Conclusions

The level of system oxidative stress increases and the inflammation is activated in TS patients.

表1 三组人群一般资料和基础生命体征比较
表2 三组人群心肌酶谱和肌钙蛋白比较(±s)
图1 三组人群心脏功能比较 注:LVEF为左心室射血分数,LVFS为左心室缩短分数;a为三组人群LVEF比较;b为三组人群LVFS比较;与健康组比较,aP<0.01
图2 三组人群血浆BNP浓度比较 注:BNP为脑钠肽;与健康组比较:aP<0.01;与AMI组比较:bP<0.01
图3 三组人群血MDA浓度比较 注:MDA为丙二醛;与健康组比较:aP<0.05;与AMI组比较:bP<0.05
图4 三组人群血浆炎症因子水平比较 注:MDA为丙二醛。IL-1β为白细胞介素-1β,IL-6为白细胞介素-6,TNF-α为肿瘤坏死因子-α;a为三组人群血浆IL-1β水平比较,b为三组人群血浆IL-6水平比较,c为三组人群血浆TNF-α水平比较;与健康组比较,aP<0.01;与AMI组相比较,bP<0.01
图5 TS患者MDA浓度与心脏功能相关性分析 注:LVEF为左心室射血分数,LVFS为左心室缩短分数,MDA为丙二醛;a为TS患者血浆MDA浓度与LVEF相关性分析,二者呈明显负相关性(P<0.001);b为TS患者血浆MDA浓度与LVFS相关性分析,二者呈明显负相关性(P<0.05)
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