慢性心力衰竭患者血清神经调节蛋白-1水平变化及意义

Changes and sinificance of serum neuregulin-1 levels in patients with chronic heart failure

目的探讨慢性心力衰竭(CHF)患者血清神经调节蛋白-1(NRG-1)水平的变化及意义。方法选取2017年10月至2018年6月郑州大学第一附属医院收治的CHF患者92例为CHF组,另选取同期年龄、性别相匹配的健康者45例为对照组。检测两组总胆固醇(TC)、低密度脂蛋白(LDL)、丙氨酸氨基转移酶(ALT)、肌酐及氨基末端B型利钠肽前体(NT-proBNP)水平,并以酶联免疫吸附法检测两组血清NRG-1水平;应用超声心动图测定左室射血分数(LVEF)及左室舒张末期内径(LVEDD)。结果两组年龄、性别、高血压及糖尿病患病率比较差异未见统计学意义(P>0.05)。CHF组肌酐、NT-proBNP、LVEDD、NRG-1水平为(82.16±22.83)μmol/L、(2834.97±2790.92)pg/ml、(56.83±11.77)mm、(1391.40±285.09)pg/ml,高于对照组的(69.87±15.92)μmol/L、(91.64±53.18)pg/ml、(44.80±3.62)mm、(1224.37±305.11)pg/ml,P<0.05;CHF组NT-proBNP、LVEDD随着LVEF降低而升高(P<0.05)。LVEF与LVEDD成强负相关关系(r=-0.868,P<0.05),与NT-proBNP成弱负相关关系(r=-0.350,P<0.05)。结论血清NRG-1可作为诊断CHF的参考指标,但用来判断CHF严重程度还需进一步探讨。

Objective To investigate the changes and sinificance of serum neuregulin-1(NRG-1)levels in patients with chronic heart failure(CHF).Methods Ninety-two patients with CHF admitted to the First Affiliated Hospital of Zhengzhou University from October 2017 to June 2018 were selected as CHF group,and 45 healthy people with similar age and gender ratios were selected as control group.Total cholesterol(TC),low density lipoprotein(LDL),alanine aminotransferase(ALT),creatinine and amino-terminal B-type natriuretic peptide(NT-roBNP)were measured in the two groups.The serum NRG-1 levels of the two groups were measured by enzyme-linked immunosorbent assay(ELISA).Left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)were determined by echocardiography.Results There was no significant difference in age,gender or prevalence of hypertension and diabetes mellitus between the two group(P>0.05).The levels of creatinine,NT-proBNP,LVEDD,and NRG-1 in CHF group were(82.16±22.83)μmol/L,(2834.97±2790.92)pg/ml,(56.83±11.77)mm,(1391.40±285.09)pg/ml,respectively,higher than(69.87±15.92)μmol/L,(91.64±53.18)pg/ml,(44.80±3.62)mm and(1224.37±305.11)pg/ml in the control group(P<0.05).NT-proBNP and LVEDD in CHF group were significantly increased with decrease in LVEF(P<0.05).LVEF had a strong negative correlation with LVEDD(r=-0.868,P<0.05),and a weak negative correlation with NT-proBNP(r=-0.350,P<0.05).Conclusions Serum NRG-1 can be used as a reference marker for the diagnosis of CHF,but it is necessary to further investigate the role in diagnosing severity of CHF.