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目的:探讨慢性心力衰竭(慢性心衰)患者血清瘦素水平之改变及其与慢性心衰基础病因、心功能分级之间的关系。方法:观察60例慢性心衰患者及30名正常人的血清瘦素水平变化,并分析不同基础病因和不同心功能分级的慢性心衰患者的血清瘦素水平。结果:慢性心衰患者的血清瘦素水平犤(12.0±3.4)μg/L犦较正常人犤(6.3±2.0)μg/L犦明显升高(P<0.01);其中冠状动脉粥样硬化性心脏病(冠心病)慢性心衰组的血清瘦素水平犤(8.7±2.3)μg/L犦较扩张型心肌病慢性心衰组高犤(3.5±1.3)μg/L犦(P<0.01)。慢性心衰患者血清瘦素水平有随心功能分级的加重而逐渐降低的趋势,但校正性别、年龄后的血清瘦素水平差异无统计学意义。3例住院期间死亡的慢性心衰患者的血清瘦素水平极低(1例女性为2.0μg/L,2例男性小于0.6μg/L)。结论:慢性心衰患者的血清瘦素水平较正常人升高,不同病因的慢性心衰患者血清瘦素水平存在差异。血清瘦素水平对严重慢性心衰患者的近期预后有预测价值。
Objective: To investigate the changes of serum leptin levels in patients with chronic heart failure (CHF) and their relationship with the underlying etiology and cardiac function of chronic heart failure. Methods: The changes of serum leptin in 60 patients with chronic heart failure and 30 normal subjects were observed. Serum leptin level was analyzed in patients with chronic heart failure with different underlying etiologies and different cardiac function classes. Results: Serum leptin levels in patients with chronic heart failure (12.0 ± 3.4) μg / L were significantly higher than those in controls (6.3 ± 2.0) μg / L (P <0.01), and coronary atherosclerosis Serum leptin level was significantly higher in chronic heart failure patients with heart disease (CHD) (8.7 ± 2.3) μg / L than that in chronic heart failure patients with dilated cardiomyopathy (3.5 ± 1.3) μg / L (P <0.01) . Serum leptin levels in patients with chronic heart failure tend to decrease with increasing severity of cardiac function, but there is no significant difference in serum leptin levels after adjustment for gender and age. Serum leptin levels were very low in 3 patients with chronic heart failure who died during hospitalization (1 in women 2.0 μg / L and 2 in men less than 0.6 μg / L). Conclusion: Serum leptin levels in patients with chronic heart failure are higher than those in normal subjects. There are differences in serum leptin levels among patients with different causes of chronic heart failure. Serum leptin levels predict the short-term prognosis of patients with severe chronic heart failure.