心力衰竭患者血浆APN和LP-PLA2水平变化

Changes of plasma APN and LP-PLA2 levels in patients with heart failure

目的探讨心力衰竭患者血清脂联素(APN)及脂蛋白相关磷脂酶A2(LP-PLA2)的水平变化,并观察其与心力衰竭程度的关系。方法收集160例心力衰竭患者作为试验组,根据纽约心脏协会分级(NYHA),分为NYHAⅡ组55例、NYHAⅢ组56例、NYHAⅣ组49例,同时选取150例健康体检者作为对照组;采用彩色多普勒超声显像仪,检测左心室射血分数(LVEF)水平,根据LVEF水平,分为LVEF>40%组76例、LVEF≤40%组84例,采用酶联免疫吸附试验法(ELISA),测定血清APN、LP-PLA2水平,同时检测相关生化指标。结果试验组N末端脑钠肽前体(NT-pro-BNP)水平较对照组明显升高,LVEF较对照组明显降低(P<0.05);与NYHAⅡ级组患者比较,NYHAⅢ级组、NYHAⅣ级组患者APN、LP-PLA2、NT-pro-BNP明显升高(P<0.05),与NYHAⅢ级组患者比较,NYHAⅣ级组患者APN、LP-PLA2、NT-pro-BNP明显升高(P<0.05);LVEF>40%患者血清APN、LP-PLA2、NT-pro-BNP水平均低于LVEF≤40%患者(P<0.05)。经Pearson直线相关分析,APN、LP-PLA2与NT-pro-BNP呈正相关(r=0.36,P<0.05),APN、LPPLA2与LVEF呈负相关(r=-0.426,P<0.05)。经二分类Logistic回归分析显示,NT-pro-BNP、APN、LP-PLA2与心力衰竭发生有关。结论 APN、LP-PLA2水平随着心力衰竭病情加重逐渐升高,可作为心力衰竭诊断及病情监测的新的标志物。

Objective To investigate the changes of serum adiponectin(APN) and lipoprotein-associated phospholipase A2(LP-PLA2) in patients with heart failure, and observe the relationship between serum LPN and LP-PLA2. Methods 160 patients with heart failure were enrolled as the experimental group. According to NY HA classification, they were divided into NYHAⅡ group(55 cases), NYHAⅢ group(56 cases), NYHAⅣ group(49 cases), and 150 healthy subjects were selected as control group. Left ventricular ejection fraction(LVEF) level was detected using a color Doppler ultrasound imaging system. According to the LVEF level, there were 76 patients with LVEF>40% and 84 patients with LVEF≤40%.Serum APN and Lp-PL A 2 were determined by enzyme-linked immunosorbent assay( ELISA). Relevant biochemical indicators were also detected simultaneously. Results The N-terminal pro-brain natriuretic peptide( NT-pro-BNP) of the experimental group was significantly higher than that of the control group, and the LVEF was significantly lower than that of the control group(P<0.05). Compared with NYHAⅡ group, APN, LP-PLA2 and NT-pro-BNP in NYHA class Ⅲ and NYHAⅣ group were significantly increased(P<0.05). Compared with NYHA class Ⅲ group, APN, LP-PLA2 and NT-proBNP in NYHAIV group were significantly increased(P<0.05). In patients with LVEF>40% HF, serum APN, LP-PLA2,and NT-pro-BNP levels were lower than those with LVEF≤40%(P<0.05). Pearson linear correlation analysis showed that APN and LP-PLA2 were positively correlated with NT-pro-BNP(r=0.360, P<0.05). APN and LP-PLA2 were negatively correlated with LVEF(r=-0.426,P<0.05). The results of two-class logistic regression analysis showed that NT-pro-BNP,APN, and LP-PLA2 were associated with heart failure. Conclusions The levels of APN and LP-PLA2 increase with the severity of heart failure, which is crucial in the development of heart failure. It may be a new anti-inflammatory factor,which can be used as a new marker for the diagnosis and monitoring of heart failure.