中国中西医结合杂志2025，Vol.45Issue(7)：799-807,9.DOI:10.7661/j.cjim.20250526.045
不同类型射血分数保留的心力衰竭与系统性炎症指标相关性
Correlation Between Subtypes of Heart Failure with Preserved Ejection Fraction and Systemic Inflammatory Markers
摘要
Abstract
Objective To identify subgroups with heightened inflammatory responses among patients with heart failure with preserved ejection fraction(HFpEF)and to predict which populations may benefit from anti-inflammatory therapy.Methods A retrospective analysis was conducted on 419 HFpEF patients.Systemic inflammatory markers were correlated with HFpEF subtypes classified by both GE's phenotyping and Chinese medicine(CM)syndrome differentiation.Results(1)The HFpEF-1+5 subgroup[meeting criteria for both vascular-related HFpEF(HFpEF-1)and extracardiac disease-related HFpEF(HFpEF-5)in GE's phenotyping]had significantly higher neutrophil to high-density lipoprotein cholesterol ratio(NHR)levels than the valvular-and rhythm-related HFpEF(HFpEF-4)and HFpEF-1+4(meeting criteria for both HFpEF-1 and HFpEF-4)subgroups,and higher systemic immune-inflammation index(SII)levels than the HFpEF-1+4 subgroup.The HFpEF-1+4+5 subgroup(fulfilling all three phenotypes:HFpEF-1,-4 and-5)had significantly elevated high sensitive C-reactive protein(hs-CRP)levels compared to the HFpEF-1 and HFpEF-1+4 subgroups,higher NHR levels than the HFpEF-4 and HFpEF-1+4 subgroups,and increased monocyte to high-density lipoprotein cholesterol ratio(MHR)levels compared to the HFpEF-1 subgroup(all P＜0.05).(2)Patiens with the CM syndrome of Yang deficiency and blood stasis with phlegm-fluid retention had significantly higher hs-CRP and MHR levels than those with Qi deficiency and blood stasis syndrome(QXXY),as well as elevated neutrophil-to-lymphocyte ratio(NLR)and system inflammation response index(SIRI)levels compared to both QXXY and Qi-Yin deficiency and blood stasis syndrome(P＜0.05).Patients with phlegm-fluid retention syndrome exhibited significantly elevated levels of hs-CRP,NLR,NHR,MHR,SII and SIRI levels than those without this syndrome(P＜0.05).Conclusions Patients with HFpEF-1+5 or HFpEF-1+4+5 subgroups,as well as those with the CM syndrome of phlegm-fluid retention,especially those with Yang deficiency and blood stasis with phlegm-fluid retention,may represent potential target populations for anti-inflammatory therapy.关键词
射血分数保留的心力衰竭/系统性炎症指标/葛氏分型/中医证型Key words
heart failure with preserved ejection fraction/GE's phenotyping/systemic inflammatory markers/Chinese medicine syndrome引用本文复制引用
王亦菲,司城玮,黄萍萍,郭丽君,马晓昌..不同类型射血分数保留的心力衰竭与系统性炎症指标相关性[J].中国中西医结合杂志,2025,45(7):799-807,9.基金项目
中国中医科学院西苑医院提升中医药临床循证证据级别研究专项(No.XYZX02101-12) （No.XYZX02101-12）
中国中医科学院西苑医院能力提升项目(No.XYZX0405-05) （No.XYZX0405-05）
