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目的探讨慢性心力衰竭患者(CHF)血清瘦素水平的变化及其与NO、ET的关系。方法选取慢性心力衰竭患者46人,另选26例健康体检者作为正常对照组,检测入选对象的血清瘦素(LPT)、一氧化氮(NO)和血浆内皮素(ET)含量等。结果心力衰竭组瘦素、一氧化氮、血浆内皮素均明显高于对照组(P<0.001)。瘦素、一氧化氮、内皮素水平随着心功能分级增加而升高;不同病因心力衰竭患者在心功能分级相同前提下瘦素、一氧化氮、内皮素水平差异无统计学意义;心力衰竭组血清瘦素、一氧化氮、血浆内皮素与射血分数有显著相关性;血清瘦素、一氧化氮、内皮素水平与NYHA分级呈正相关;瘦素、内皮素为独立预测心功能的因子。结论血清瘦素、一氧化氮、血浆内皮素水平增高是慢性心力衰竭病理生理特征之一,并影响射血分数和心功能受损程度;瘦素、内皮素检测可以做为独立预测心功能的方法。
Objective To investigate the changes of serum leptin and its relationship with NO and ET in patients with chronic heart failure (CHF). Methods Forty-six patients with chronic heart failure and 26 healthy subjects were selected as normal control group. The levels of serum leptin (LPT), nitric oxide (NO) and plasma endothelin (ET) were measured. Results The levels of leptin, nitric oxide and plasma endothelin in heart failure group were significantly higher than those in control group (P <0.001). Leptin, nitric oxide and endothelin levels increased with the increase of heart function. Leptin, nitric oxide and endothelin levels in heart failure patients with different etiologies were not significantly different, Serum leptin, nitric oxide, plasma endothelin and ejection fraction were significantly correlated; serum leptin, nitric oxide and endothelin levels were positively correlated with NYHA classification; leptin and endothelin were independent predictors of cardiac function. Conclusion The increase of serum leptin, nitric oxide and plasma endothelin levels is one of the pathophysiological features of chronic heart failure and affects the ejection fraction and the impairment of cardiac function. The detection of leptin and endothelin can be used as an independent predictor of cardiac function method.