心肾综合征患者血清肥胖抑制素水平及其临床意义研究

Level and clinical significance of serum obestatin in patients with cardiorenal syndrome

目的探讨心肾综合征(CRS)患者血清肥胖抑制素水平及其临床意义。方法选择该院2013年6月至2014年6月住院治疗的30例CRS患者作为CRS组(所有患者均为CRSⅡ型),50例慢性心功能不全(CHF)患者作为CHF组,40例慢性肾功能不全(CKD)患者作为CKD组,选择同期该院体检健康的30例志愿者作为对照组。检测各组患者血清中的肥胖抑制素和精氨酸加压素(VAP)水平,并进行统计学分析。结果 CRS组患者VAP水平最高[(69.2±28.2)pg/mL],并明显高于另两组患者(P<0.05)。CHF组与CKD组比较,差异无统计学意义(P>0.05)。CRS组患者肥胖抑制素水平最高[(361.2±78.7)pg/mL],并明显高于CKD组的(285.4±64.9)pg/mL和CHF组的(279.5±126.1)pg/mL(P<0.05)。CKD组与CHF组比较,差异无统计学意义(P>0.05)。通过Pearson相关性分析对肥胖抑制素和VAP及其他相关生化指标进行分析后发现,肥胖抑制素水平与VAP和BNP水平呈正相关(rVAP=0.302,rBNP=0.323,P<0.05)。结论 CRS患者体内肥胖抑制素和VAP水平较单纯CHF和CKD患者明显升高,并且肥胖抑制素与VAP呈正相关,可能调节VAP的合成与分泌,提示二者可能参与CRS的发生和发展。

Objective To investigate the level and clinical significance of serum obestatin in the patients with cardiorenal syndrome（CRS） .Methods Thirty CRS（type II） inpatients in our hospital from June 2013 to June 2014 were selected as the CRS group ,50 patients with chronic heart failure（CHF） as the CHF group ,40 patients with chronic kidney disease（CKD） as the CKD group and contemporaneous 30 volunteers of physical examination as the control group .The serum obestation and vasopressin（VAP） levels in each group were measured by ELISA and the detection results were performed the statistical analysis .Results The VAP level in the CRS group was highest [（69 .2 ± 28 .2 ）pg/mL] ,which was significantly higher than that in the CHF group and the CKD group（P〈 0 .05） , while no statistically significant difference could be found between the CHF group and the CKD group（P 〉0 .05） . The obestatin level in the CRS group was highest [（361 .2 ± 78 .7 ）pg/mL ] ,which was significantly higher than （285 .4 ± 64 .9）pg/mL and （279 .5 ± 126 .1）pg/mL in the CKD group and the CHF group respectively （P 〈 0 .05） , while no statistically significant difference could be found between the CKD group and the CHF group（P 〉 0 .05） . The Pearson correlation analysis found that the obestatin was positively correlated with VAP（rVAP = 0 .302 ,rBNP = 0 . 323 ,P〈 0 .05） .Conclusion The levels of VAP and obestitin in CRS patients are increased compared with simple CHF and CKD ,moreover obestitin shows a positive relation with VAP and could adjust the synthesis and secretion of VAP ,prompting that these two factors may participate in the occurrence and development of CRS .