慢性心力衰竭患者血浆中松弛素-2的水平及其与心衰预后关系的研究

Level of Relaxin-2 in serum of patients with chronic heart failureand its relationship with the prognosis of chronic heart failure

目的观察慢性心力衰竭(chronic heart failure,CHF)患者血浆中松弛素-2(Relaxin-2)的浓度,并探讨其与CHF患者发生主要心血管不良心脏事件(MACE)的关系。方法纳入NYHA分级为Ⅲ~Ⅳ级的发生MACE的CHF患者36例作为病例组,142例未发生MACE的CHF患者作为对照组。用ELISA方法检测两组患者血浆中Relaxin-2与BNP的浓度。采用单因素以及多因素logistic回归分析CHF患者发生MACE的危险因素。结果病例组血浆中Relaxin-2浓度为(0.50±0.10) pg/mL高于对照组的(0.43±0.11) pg/mL (P=0.001)。病例组血浆中BNP浓度为(589.44±152.13) pg/mL高于对照组的(506.06±99.33) pg/mL (P<0.01)。血浆中Relaxin-2与BNP的浓度呈显著正相关(ρ=0.159,P=0.034)。Logistic回归分析显示血浆中Relaxin-2浓度(OR=1.009,95%CI:1.003~1.015),血浆中BNP的浓度(OR=1.005,95%CI:1.000~1.009)以及患者的左室射血分数(OR=0.636,95%CI:0.546~0.740)是发生MACE的独立相关因素。结论 CHF患者血浆中Relaxin-2浓度是发生MACE的危险因素,它可作为预测CHF患者发生MACE的指标之一。

Objective This study was aimed to measure the concentration of relaxin-2 in the serum of patients with chronic heart failure(CHF),and to evaluate its relationship with the experienced major adverse cardiac events(MACE) among CHF patients. Methods 36 patients with CHF who experienced MACE and belonged to III-IV level of NYHA classification were selected as the case group and 142 patients with CHF who did not experienced MACE were selected as the control group.The concentrations of Relaxin-2 and BNP in serum of the patients from both groups were measured by ELISA.Single-factor analysis and multivariate logistic regression modeling were used to assess the risk factors for MACE in patients with CHF.Results The serum relaxin-2 concentration of the patients in case group[(0.50±0.10)pg/mL] is higher than that in control group[(0.43±0.11) g/mL](P=0.001). The serum BNP concentrations in the case group[(589.44±152.13) pg/mL]were also significantly higher than in those of the control subjects[(506.06±99.33)pg/mL](P<0.001). The serum relaxin-2 concentration was positively correlated with the serum BNP concentration(ρ= 0.159,P=0.034). Logistic regression analysis revealed relaxin-2 level(OR=1.009,95%CI:1.003~1.015),BNP level(OR=1.005,95%CI:1.000~1.009) and the left ventricular ejection fraction(LVEF)(OR=0.636,95%CI:0.546~0.740) are independent association factors for MACE in patients with CHF.Conclusion The serum relaxin-2 level in CHF patients is an independent risk factor for MACE,so it can be used as a predictor of MACE in patients with CHF.