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目的探讨慢性心力衰竭(Chronic heart failure,CHF)患者血浆脂联素(Adiponectin,APN)水平的变化及其与脑钠肽(Brain natriuretic peptide,BNP)及左室重量指数(Left ventricular mass index,LVMI)的相关性,评价APN水平在预测心衰进程及预后中的价值。方法分别选取90例男性CHF患者及90名男性健康查体者(对照组),应用ELISA法测定血浆APN和BNP水平,通过超声心动图测定左室舒张末期室间隔厚度、左室后壁厚度、左室舒张末期内径、左室舒张末期容积和收缩末期容积,计算LVMI,比较CHF患者和对照组的APN、BNP和LVMI水平;不同病因所致CHF患者血浆APN和LVMI的水平;不同心功能患者血浆APN和BNP的水平;并进行APN与BNP及LVMI的相关性分析。结果 CHF患者血浆APN和BNP水平及LV-MI均明显高于对照组(P均<0.05);不同病因所致CHF患者的APN水平差异无统计学意义(P>0.05);NYHAⅣ患者血浆APN和BNP水平明显高于NYHAⅢ及NYHAⅡ患者(P均<0.05);APN与BNP和LVMI均呈正相关(r=0.528,P<0.001;r=0.269,P<0.05)。结论 CHF患者血浆APN水平随心功能的恶化而增高,并可能参与心肌重塑的病理生理过程,测定CHF患者血浆APN水平有可能作为预测CHF进程及评价预后的重要指标。
Objective To investigate the changes of plasma adiponectin (APN) in patients with chronic heart failure (CHF) and its relationship with the levels of brain natriuretic peptide (BNP) and left ventricular mass index (LVMI) ), And to assess the value of APN in predicting the course and prognosis of heart failure. Methods Ninety male patients with CHF and 90 healthy people (control group) were enrolled in this study. Plasma APN and BNP levels were measured by ELISA. The left ventricular end-diastolic ventricular septal thickness, left ventricular posterior wall thickness, Left ventricular end-diastolic diameter, left ventricular end-diastolic volume, and end-systolic volume were calculated LVMI, compared CHF patients and control group APN, BNP and LVMI levels; different causes of CHF plasma APN and LVMI levels; patients with different cardiac function Plasma APN and BNP levels; and APN and BNP and LVMI correlation analysis. Results The levels of plasma APN, BNP and LV-MI in patients with CHF were significantly higher than those in controls (all P <0.05). There was no significant difference in the APN levels between CHF patients with different etiologies (P> 0.05) BNP levels were significantly higher in patients with NYHA III and NYHAⅡ (all P <0.05). There was a positive correlation between APN and BNP and LVMI (r = 0.528, P <0.001; r = 0.269, P <0.05). Conclusions Plasma APN level in CHF patients is increased with the deterioration of cardiac function and may be involved in the pathophysiological process of myocardial remodeling. The determination of plasma APN levels in CHF patients may be an important index for predicting CHF progression and prognosis.