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目的探讨血浆脂联素(adiponectin,APN)水平在射血分数正常心力衰竭(HFNEF)和射血分数下降心力衰竭(HFREF)患者中的变化及其与HFNEF患者预后的关系。方法检测90例HFREF患者和56例HFNEF患者血浆APN和氨基末端脑利钠肽前体(NT-proBNP)水平,行多普勒超声心动图检查,对所有出院患者进行随访,平均随访12个月(8～16个月),观察心血管事件(心力衰竭加重导致再入院和死亡)再发情况。结果血浆APN水平HFNEF组低于HFREF组,分别为(8.13±2.48)、(12.46±4.87)μg/ml,P=0.000;HFNEF组APN水平与NT-proBNP水平和左室质量指数(LVMI)呈正相关(r=0.868,P=0.000;r=0.350,P=0.000);APN和NT-proBNP水平是HFNEF预后的独立预测因子(P=0.000;P=0.001)。结论 HFNEF患者血浆APN水平低于HFREF患者,APN水平可能与NT-ProBNP联合起来成为预测HFNEF患者预后的特异性指标。
Objective To investigate the changes of plasma adiponectin (APN) levels in patients with HFNF and HFREF and their relationship with the prognosis of patients with HFNEF. Methods Plasma levels of APN and NT-proBNP were measured in 90 patients with HFREF and 56 patients with HFNEF. All patients were followed up for 12 months by Doppler echocardiography. (8-16 months) to observe the recurrence of cardiovascular events (re-admission and death due to increased heart failure). Results Plasma APN levels in HFNEF group were significantly lower than HFREF group (8.13 ± 2.48), (12.46 ± 4.87) μg / ml, P = 0.000 respectively. APN level in HFNEF group was positively correlated with NT-proBNP level and LVMI (R = 0.868, P = 0.000; r = 0.350, P = 0.000). APN and NT-proBNP levels were independent predictors of HFNEF prognosis (P = 0.000; P = 0.001). Conclusions Plasma APN levels in patients with HFNEF are lower than those in patients with HFREF. The level of APN may be associated with NT-ProBNP as a predictor of prognosis in patients with HFNEF.