慢性心力衰竭患者血清脂联素水平改变及其临床意义的研究

Serum Adiponectin Level in Patients with Chronic Heart Failure and Its Clinical Significance

目的探讨慢性心力衰竭(CHF)患者血清脂联素(APN)水平改变及其与CHF患者心功能、超敏C反应蛋白(hs-CRP)、尿酸(UA)的相关性。方法选择CHF患者60例为心力衰竭组,然后按NYHA心功能分级将其分为3组,心功能Ⅱ级组25例,心功能Ⅲ级组21例,心功能Ⅳ级组18例;根据CHF病因分为冠心病组、高血压性心脏病组及扩张性心肌病组。选择同期无器质性心脏病且心功能正常的阵发性室上性心动过速(PSVT)患者20例作为对照组。采用酶联免疫吸附法测定血清APN水平,免疫比浊法测定hs-CRP、UA。结果心力衰竭组与对照组APN水平、hs-CRP、UA比较,差异均有统计学意义(P<0.05);不同心功能组间APN水平比较,差异无统计学意义(F=0.308,P>0.05);治疗前后心力衰竭组APN水平比较,差异有统计学意义(P<0.05)。APN与hs-CRP、UA呈正相关(r=0.325,P=0.009;r=0.248,P=0.048)。结论心力衰竭患者血清APN水平明显升高,且随着心功能损害程度加重而升高更加明显,APN在心力衰竭发展过程中起着重要作用,可作为评价心力衰竭患者病情严重程度的易测指标。

Objective Chronic heart failure（CHF） patients serum adiponectin（APN） level and heart function of the patients with CHF,high sensitive C reactive protein（hs-CRP）,uric acid（UA） correlation.Methods Select CHF in 60 patients with heart failure group,then according to the classification of NYHA will be divided into 3 groups,heart functionⅡgroup 25 cases,heart function Ⅲgroup 21 cases,heart function Ⅳ18 cases;according to the etiology of CHF is divided into a group of coronary heart disease,hypertensive heart disease and dilated cardiomyopathy group.Select the same period without organic heart disease and cardiac function of normal paroxysmal supraventricular tachycardia（PSVT） heartbeat in 20 cases as the control group.Using enzyme-linked immunosorbent assay of serum APN levels,immune turbidimetric method for the determination of hs-CRP,UA.Results Heart failure group and the control group APN,hs-CRP,UA horizontal comparison,the differences were statistically significant（P0.05）;cardiac function between group APN level to compare,the difference was not statistically significant（F=0.308,P0.05）;heart failure before and after treatment in group APN level to compare,the difference was statistically significant（P0.05）.APN and hs-CRP,UA were positively correlated（r=0.325,P=0.009;r=0.248,P=0.048）.Conclusion The level of the adiponectin in heart failure was found to increase along with the degree of the cardiac function.The important role of adiponectin in the process of heart failure may justify its use as a biomarker for this condition.