慢性心力衰竭患者血浆脂联素与脑钠肽及左室重量指数的相关性

Relationship of Adiponectin in Plasma to Brain Natriuretic Peptide and Left Ventricular Mass Index of Patients with Chronic Heart Failure

目的探讨慢性心力衰竭(Chronic heart failure,CHF)患者血浆脂联素(Adiponectin,APN)水平的变化及其与脑钠肽(Brain natriuretic peptide,BNP)及左室重量指数(Left ventricular mass index,LVMI)的相关性,评价APN水平在预测心衰进程及预后中的价值。方法分别选取90例男性CHF患者及90名男性健康查体者(对照组),应用ELISA法测定血浆APN和BNP水平,通过超声心动图测定左室舒张末期室间隔厚度、左室后壁厚度、左室舒张末期内径、左室舒张末期容积和收缩末期容积,计算LVMI,比较CHF患者和对照组的APN、BNP和LVMI水平;不同病因所致CHF患者血浆APN和LVMI的水平;不同心功能患者血浆APN和BNP的水平;并进行APN与BNP及LVMI的相关性分析。结果 CHF患者血浆APN和BNP水平及LV-MI均明显高于对照组(P均<0.05);不同病因所致CHF患者的APN水平差异无统计学意义(P>0.05);NYHAⅣ患者血浆APN和BNP水平明显高于NYHAⅢ及NYHAⅡ患者(P均<0.05);APN与BNP和LVMI均呈正相关(r=0.528,P<0.001;r=0.269,P<0.05)。结论 CHF患者血浆APN水平随心功能的恶化而增高,并可能参与心肌重塑的病理生理过程,测定CHF患者血浆APN水平有可能作为预测CHF进程及评价预后的重要指标。

Objective To investigate the relationship of adiponectin（APN）in plasma to brain natriuretic peptide（BNP）and left ventricular mass index（LVMI）of patients with chronic heart failure（CHF）,and evaluate the value of APN level in predicting the process and prognosis of CHF.Methods Ninety male patients with CHF and 90 healthy men were determined for APN and BNP levels in plasma by ELISA,for IVST,PWT,LVIDd,LVEDV and LVESV by echocardiography,based on which LVMI was calculated.The APN,BNP and LVMI were compared between the patients with CHF and control,the patients with CHF due to various causes,and the APN and BNP levels between patients with various degrees of cardiac functions,based on which the relationship of APN to BNP and LVMI was analyzed.Results The APN and BNP levels in plasma as well as LVMI of patients with CHF were significantly higher than those of healthy men（P 〈0.05）.The APN levels of patients with CHF due to various causes showed no significant difference（P 〉0.05）.Both the APN and BNP levels of patients with NYHA Ⅳ were significantly higher than those with NYHA Ⅲ and with NYHA Ⅱ（P 0〈.05）.APN was positively related to both BNP and LVMI（r = 0.528,P 〈0.001;r = 0.269,P〈 0.05）.Conclusion The APN level in plasma of patients with CHF increased with the deterioration of heart function,and might participate in the pathophysiological process of myocardial remodeling,which might be used as an important indicator for predicting the process and evaluating the prognosis of CHF.