冠心病合并心力衰竭患者血清脂联素水平变化

The changers of serum adiponectin levels in patients with coronary heart disease combined with congestive heart failure

目的探讨冠心病合并心力衰竭患者血清脂联素水平的变化及其临床意义。方法选择冠心病患者60例、冠心病合并心力衰竭患者60例[其中心功能（NYHA）Ⅱ级18例、心功能Ⅲ级27例、心功能Ⅳ级15例]、健康对照组25例，测定血清脂联素并对其变化进行两两比较。结果冠心病合并心力衰竭患者血清脂联素为（14．22±5．34）mg／L；冠心病无心力衰竭组血清脂联素为（4．79±1．61）mg／L；健康对照组为（6．98±1．62）mg／L，两两比较差异有统计学意义（P〈0．01）。冠心病合并心力衰竭患者随着心功能分级的升高，血清脂联素水平也显著升高[NYHAII级为（9．25±2．71）mg／L，NYHAⅢ级为（13．72±3．38）mg／L，NYHAIV级为（18．0±6．72）mg／L，P〈0．01]。结论合并心力衰竭的冠心病患者血清脂联素水平是升高的，且随着心功能分级的升高，血清脂联素水平也明显升高。血浆脂联素可能参与冠心病及心力衰竭的发病机制，血清脂联素水平变化对心力衰竭的进展和程度有一定的指导意义。

Objective To investigated the changes and clinical significance of serum adiponectin levels in patients with coronary heart disease （CHD） combined with congestive heart failure （CHF）. Methods The total 145 persons were divided into 3 groups, including coronary heart disease （CHD） 60 patients, coronary heart disease （CHD） combined with congestive heart failure （CHF） 60 patients（NYHA Ⅱ class 18 patients, NYHA Ⅲ class 27 patients, NYHA Ⅳ class 15 patients）. The other 25 healthy people were taken as the contrals. The serum adipenectin of all people was tested and the changes of them were analyzed. Results The serum adipenectin levels were （14.22±5.34）rag/L, （4.79±1.61）mg/L and （6.98±1.62）mg/L respectively in patients with coronary heart disease （CHD） combined with congestive heart failure （CHF）, coronary heart disease （CHD）, and healthy control group, The serum adiponectin in the patients with CHD combined CHF was higher than in healthy control group （P〈0.01）, and the serum adipenectin levels were significantly increased according to the severity of NYHA class in CHF group [ NYHA Ⅱ class （9.25±2.71 ）rag/L, NYHA Ⅲ class （ 13.72±3.38 ）mg/L, NYHA Ⅳ class （ 18.0±6.72 ）mg/L, P〈0.01 ]. Conclusion Serum adipenectin levels may be involved in the pathogenesis of CHD and CHF. The change of the serum adiponenctin is possibly valuable for evaluating the heart function and the prognosis of CHF.