血浆脂联素和B型钠尿肽水平在慢性充血性心衰患者心功能评价中的应用价值

Application value of plasma adiponectin and B-type natriuretic peptide for evaluating the cardiac function in patients with chronic congestive heart failure

目的:探讨血浆脂联素(APN)和B型钠尿肽(BNP)水平检测在慢性充血性心力衰竭(CHF)患者心功能评价中的临床应用价值,为其临床研究提供可参考依据。方法:共纳入120例诊断为CHF患者作为病例组,同时从门诊随机抽取35例无心脏疾病史的人群作为对照组。病例组患者于治疗前、治疗后3周,对照组于纳入本研究当日抽取空腹肘正中静脉血,采用双抗体夹心ELISA法检测APN和BNP水平,分析其与CHF患者心功能等级的关系。结果:与对照组相比,心功能Ⅱ～Ⅳ级患者血浆APN、BNP水平均明显比较高,差异比较有统计学意义(P<0.05);对NYHA不同等级间血浆APN、BNP水平分析发现,随着心功能等级的增高,其血浆APN、BNP水平逐渐上升,差异比较亦有统计学意义(P<0.05)。与治疗前相比,治疗后所有患者血浆APN、BNP水平均有明显下降,两者相比差异有统计学意义(P<0.05)。进一步行相关性分析显示,血浆APN、BNP水平随着CHF患者NYHA等级的升高而上升,相关系数r分别为0.986、0.977(P<0.01),呈明显正相关。结论:APN和BNP水平检测在CHF患者心功能评价中有重要的临床应用价值,其可以随着心功能严重程度的增加而增加,因此APN和BNP水平的检测可以更好了解患者病情的发展及转归。

Objective. To investigate the application value of plasma adiponectin（APN） and B-type natriuretic peptide（BNP） for evaluating the cardiac function in patients with chronic congestive heart fail- ure（CHF）. Methods. Participants included 120 cases of CHF patients （Case group）, and35 patients with no history of heart disease were randomly enrolled as control group. Fasting venous blood was collectedfrom case group before and 3 weeks after treatment to detect the APN and BNP level with ELISA method in order to analyze its relationship with cardiac function level of CHF patients. Results： Comparedwith control group, the serum APN level and BNP level in patients with Ⅱ～Ⅳ heart function were significant- ly higher than those of the control group （P〈0.05）. According to analysis of patients with different NY- HA grade, plasma APN, BNP levels increased with cardiac function level and the difference were signifi- cant （P〈0.05）. APN, BNP levels decreased significantly after treatment comparing with levels before the treatment, and line correlation analysis showed that the plasma APN, BNP levels increased with the rising of NYHA grade in CHF patients, the correlation coefficient r was 0. 986 and 0. 986 （P〈0. 01）, respec- tively. Conclusion： APN and BNP level in CHF patients has important clinical value in the assessment of cardiac function, it increase with the severity of cardiac function, so detection of APN and BNP levels can help to understand the development and outcome of patients of the disease better.