心力衰竭患者体重指数与apelin、血管紧张素Ⅱ的关系

Relationship of body mass index to plasma apelin and angiotension Ⅱin heart failure patients

目的探讨充血性心力衰竭(CHF)患者的体重指数(BMI)与血浆apelin、血管紧张素Ⅱ(AngⅡ)等因素的关系。方法41例心力衰竭患者,男20例,女21例,平均年龄(66±12.3)岁,按BMI分为正常体重组16例、超重组13例、肥胖组12例,按照心功能分级分为心功能Ⅲ级22列,心功能Ⅳ级19例。用酶联免疫吸附法测定各组的血浆apelin、AngⅡ水平。结果肥胖组apelin水平为(0.48±0.15)ng/ml,明显高于正常体重组[(0.18±0.15)ng/ml]及超重组([0.27±0.06)ng/ml],而超重组又明显高于正常体重组(P<0.01)。心功能Ⅳ级患者的apelin水平为(0.35±0.16)ng/ml,显著高于心功能Ⅲ级的患者[(0.26±0.13)ng/ml,P﹤0.05]。心功能Ⅳ级患者的AngⅡ水平为(0.34±0.15)ng/ml,显著高于心功能Ⅲ级的患者[(0.23±0.09)ng/ml,P﹤0.05]。心力衰竭患者的血浆apelin水平与BMI成正相关、而AngⅡ水平与BMI无关;血浆apelin、AngⅡ水平之间无相关关系。结论肥胖的心力衰竭患者的血浆apelin水平较高,可能是其生存率提高的因素之一;心力衰竭患者测定apelin、AngⅡ可作为判断病情的一个指标。

Objective To investigate the relationship of body mass index （BMI） to plasma apelin and angiotension Ⅱ （Ang Ⅱ） in congestive heart failure （CHF） patients. Methods enzyme linked immunosorbent assay, （ELISA） was used to detect the levels of plasma apelin and Ang Ⅱ of 41 CHF patients, 20 males and 21 females, aged （66±12.3）, 16 with normal body weight, 13 overweight, and 12 obese, 22 with cardiac function of grade Ⅲ and 19 with cardiac function of grade IV. Results The apelin levels of the obese group was （0.48±0.15）ng/ml, significantly higher than those of the normal weight group [（0.18,± 0.15）ng/ml] and overweight group [（0.27±0.06）ng/ml]; and that of the overweight group was significantly higher than that of the normal weight group （all P〈0.01）. There was no significant difference in the Ang Ⅱ level among the 3 groups （all P〉0.05）. The plasma apelin level of the cardiac function 1V group was （0.35 ±0.16 ）ng/ml, significantly higher than that of the cardiac func- tion llI group [（0.26.±0.13 ） ng/ml ,P 〈 0.05]. The plasma Ang 11 level of the cardiac function IVgroup was （0.34.±0.15）ng/ml, significantly higher than that of the cardiac function Ⅲ group [（0.23_±0.09）ng/ml,P 〈 0.05]. In the CHF patients the plasma apelin level was positively correlated with the BMI, and there was not significant correlation between the plasma apelin level and Ang Ⅱ level. Cone I us i on The high plasma apelin level of obese CHF patients may be one of the factors of the higher survival rate of the patients. Plasma apelin and Ang Ⅱ levels may be used as indicators of state of illness.