急性淋巴细胞白血病患者血清瘦素表达水平的研究

目的 研究急性淋巴细胞白血病(ALL)患者血清瘦素水平变化的临床意义.方法 选取ALL患者及健康成人各20例,分别以放射免疫法测定其血清瘦素水平,并在化疗2个周期后再次测定ALL患者血清瘦素水平.结果 ALL组化疗前血清瘦素水平明显低于健康对照组[(19.2±4.5)μg/L比(33.9±6.2)μg/L,P<0.05].ALL组化疗后血清瘦素水平[(28.9±5.5)μg/L]明显高于化疗前(P<0.05).结论 ALL患者血清瘦素水平较健康成人低,经化疗缓解后,其血清瘦素水平明显增高.血清瘦素水平可作为判断ALL治疗效果的有效指标之一.

Abstract：

Objective To investigate the level of plasma leptin in patients with acute lymphoblastic leukemia (ALL) , and to compare the difference of plasma leptin levels in patients with ALL respectively before and after chemotherapy in order to discuss the relationship between ALL and plasma leptin level. Methods There were 20 cases in ALL group and 20 normal persons in control group. We examined the expression of the levels of leptin in plasma with ALL patients respectively before (group A) and after 2 circles chemotherapy (group C) and normal persons (group B) using radioimmunoassay method. Results The leptin levels of group A and B were( 19. 2 ± 4.5) n,g/L and (33.9 ±6. 2) p,g/L respectively with significant statistical difference. The leptin levels of group A and C were(19.2 ±4.5)μg/L and (28.9 ±5.5)μg/L respectively. Conclusions The plasma leptin level in patients with ALL is lower than that in normal persons. After chemotherapy the plasma leptin level is markedly higher than before. The leptin level of plasma can be used as a helpful indicator to evaluate the therapeutic effect of patients with ALL.     

老年肺心病患者并发心律失常相关危险因素分析

Objective To investigate the risk factors influencing the occurrence of cardiac arrhythmia following pulmonary heart disease in elderly patients. Methods Totally 80 cardiac arrhythmia and 28 non-cardiac arrhythmia in elderly patients with pulmonary heart disease cases were analyzed. Results Eighty cases were complicated with cardiac arrhythmias with the incidence of 74.1%. The logistic regression analysis indicated that concomitant disease, hypoxemia, heart failure, lung infection, Acid-base inbalance, electrolyte disturbance were significant risk factors (P ＜ 0.05 ). Conclusions Cardiac arrhythmia in elderly patients with pulmonary heart disease should be strengthened. Early diagnosis and treatment must be addressed according to the risk factors.     

老年肺心病患者并发心律失常相关危险因素分析

Objective To investigate the risk factors influencing the occurrence of cardiac arrhythmia following pulmonary heart disease in elderly patients. Methods Totally 80 cardiac arrhythmia and 28 non-cardiac arrhythmia in elderly patients with pulmonary heart disease cases were analyzed. Results Eighty cases were complicated with cardiac arrhythmias with the incidence of 74.1%. The logistic regression analysis indicated that concomitant disease, hypoxemia, heart failure, lung infection, Acid-base inbalance, electrolyte disturbance were significant risk factors (P ＜ 0.05 ). Conclusions Cardiac arrhythmia in elderly patients with pulmonary heart disease should be strengthened. Early diagnosis and treatment must be addressed according to the risk factors.     

出血性疾病患者血浆血栓调节蛋白检测的临床意义

目的 探讨出血性疾病患者血浆血栓调节蛋白(TM)含量变化与临床病情的关系.方法 用双抗体夹心酶联免疫吸附法(ELISA)检测50例出血性疾病患者[其中过敏性紫癜25例,免疫性血小板减少症(ITP)25例]血浆TM含量,同样方法检测健康对照组40例,比较3组的TM水平.结果 过敏性紫癜患者血浆TM含量[(32.55±7.48)μg/L]明显高于健康对照组[(20.4±7.72)μg/L](t=6.90,P<0.01);ITP患者血浆TM水平[(20.29±10.15)μg/L]未见明显升高(P>0.05);过敏性紫癜治疗好转组血浆TM含量[(20.15±8.02)Ixg/L]明显下降(t=6.46,P<0.01),而无效和复发组患者血浆TM含量分别为[(33.76±8.36)μg/L]和[(34.06±10.06)μg/L],与好转组比较差异有统计学意义(P<0.01).结论 血浆TM水平的检测有助于对过敏性紫癜和ITP的鉴别诊断.过敏性紫癜患者血浆TM含量与临床病情变化密切相关,可作为了解病情、观察疗效、判断预后的指标之一.

Abstract：

Objective To investigate the relationship between plasma thrombomodulin(TM)concentration and clinical condition in hemorrhagic disease.Methods Enzyme-linked immunoabsorbent assay(ELISA)was a-dopted to detect the plasma TM concentration of 50 patients(25 were allergiC purpura,the other 25 were idiopathicthrombocytopenia purpura)and 40 healthy people in control group.Results The plasma TM concentration of aller-sic purpura group[(32.55±7.48)μg/L]was significantly higher than that of control group[(20.40±7.72)μg/L](P<0.01).The plasma TM concentration of the idiopathic thrombocytopenia purpura(ITP)group was not increasing[(20.29±10.15)μg/L](P>0.05).The plasma TM concentration of the improved allergic purpura group [(20.15±8.02)μg/L]decreased signiflcanfly(P<0.01),while that of the inefficient group[(33.76±8.36)μg/L]and relapse group[(34.06±10.06)μg/L]increased significantly(P<0.01).Conclusions Plasma TM concentration detection helps diagnose two types of hemorrhagic disease.The plasma TM concentration of the allergic purpura is closely related with the clinical situation,therefore it call be used as one of the indexes for learning the state of the disease,observing the curative effect and estimating prognosis.     

Targeting at SUR2B/Kir6.1 subtype of ATP-sensitive potassium channel opener natakalim improves pressure overload-induced heart failure

Objective To explore the new stratigies targeting at SUR2B/Kir6.1 subtype against pressure overload-induced heart failure.Methods Pressure overload-induced heart failure was induced in Wistar rat by abdominal aortic banding(AAB).The effects of natakalim(1,3,9 mg·kg-1·d-1,10 weeks)were assessed on myocardial hypertrophy and heart failure,cardiac histology,vasoactive compounds,and gene expression.Isolated working heart and isolated tail artery helical strips were used to examine the influence of natakalim on heart and resistant vessels.Results Ten weeks after the onset of pressure overload,natakalim therapy potently inhibited cardiac hypertrophy and prevented heart failure.Natakalim inhibited the changes of left ventricular haemodynamic parameters,reversed the increase of heart mass index,left ventricular weight index and lung weight index remarkably.Histological examination demonstrated that there were no significant hypertrophy and fibrosis in hearts of pressure overload rat treated with natakalim.Ultrastructural examination of heart revealed well-organized myofibrils with mitochondria grouped along the periphery of longitudinally oriented fibers in natakalim group rats.The content of serum NO and plasma PGI2 was increased,while that of plasma ET-1 and cardiac tissue hydroxyproline,ANP and BNP mRNA was down-regulated in natakalim-treated rats.Natakalim at concentrations ranging from 0.01-100 μM had no effects on isolated working heart derived from Wistar rats;however,natakalim had endothelium-dependent vasodilation effects on the isolated tail artery helical strips precontracted with NE.Conclusions These results indicate that natakalim improves heart failure due to pressure overload by activating KATP channel SUR2B/Kir6.1 subtype and reversing endothelial dysfunction.     

2型糖尿病患者血浆内皮素测定及其意义初探

Objective This study aimed to determine the change of plasma endothelin (ET) in patients with diabetes meUitus .Methods 42 diabetic patients and 50 normal people were included in our study.The diabetic patients were divided into 2 groups, one group with vascular complications, and the other one without. The plasma ET, blood pressure,fasting blood glucose and other intems were measured in these people. Result The plasma ET level was found to be greatly elevated in diabetic patients comparing with the normal people and ET level of diabetic patients with vascular complication was much higher than patients without complications. The plasma ET level had positive correlation with systolic pressure in diabetic patients. Conclusion The result indicated that the high level of plasma ET might play an improtant role in the occurrence and development of vascular complication. The level of plasma ET should be routinely measured in diabetic patients. The patients with high - level plamsa ET should take therapeutic measures to prevent the occurrence of vascular complication.     

沙美特罗/氟替卡松对慢性阻塞性肺疾病患者急性加重期气道炎症的影响

Objective To investigate the influence of salmeterol with fluticasone on airway inflammation of patients with acute exacerbation chronic obstructive pulmonary disease (COPD).Methods 40 COPD patients in the stage of acute exacerbation were randomly divided into salmeterol with fluticasone group( A group) and controll group (B group).Bronchial alveolar lavage( BAL) was performed as usual.The concentrations of IL-8 and TNF-α in bronchial alveolar lavage fluid(BALF) were measured by ELISA.The results were compared with that of 18 healthy volunteers.Results The levels of IL-8 and TNF-a in BALF of patients in A group(10.60 ± 1.42) μg/L, (14.80 ± 2.05) μg/Land B group( 10.77 ± 1.98) μg/L, (14.70 ± 2.03) μg/L were significantly higher than that of C group (3.40 ±0.65)μg/L, (4.67 ± 1.01) μg/L( all P <0.01) ;Before treatment,the levels of IL-8 and INF-α in BALF of A group( 10.60 ± 1.42)μg/L,(14.80 ±2.05) μg/L and B group( 10.77 ± 1.98) μg/L,(14.70 ±2.03) μg/L had no significant differences (all P > 0.05) ,and the concentrations of IL-8 and TNF-a in BALF in group A (4.39 ± 0.92)μg/L,(5.84 ±1.26) μg/L were significantly lower than that in group B(9.69 ± 1.43) μg/L, (12.88 ± 2.51) μg/L after two weeks treatment ( all P < 0.01).Conclusion Salmeterol with fluticasone could inhibit airway inflammation of COPD patients in the stage of acute exacerbation.     

Factors responsible for interindividual differences in the dose requirement of phenprocoumon

Summary The total and unbound plasma concentrations of phenprocoumon and the prothrombin complex activity were determined in 51 patients on phenprocoumon. A 7-fold difference in the dosing rate (10–70 μg/kg/day) was required to maintain the prothrombin complex activity at 11–30% of normal. The variation in dosing requirement was mainly due to inter-individual differences in the intrinsic clearance of phenprocoumon and only to a minor degree to differences in sensitivity to it. On average patients with myocardial infarction required only 2/3 of the daily dose of phenprocoumon of post cardiac surgery patients and patients with thrombosis and emboli. That difference appeared to be due to higher clearance in surgical patients and to greater resistance to phenprocoumon in patients with thrombosis and emboli. The total clearance in patients varied approximately 5-fold. It was better predicted by the interindividual intrinsic clearance (r=0.84) than by the unbound fraction (r=0.15).     

冠心病患者冠脉支架植入前后Hs-CRP含量的变化及意义

Objective To detect the concentration of C-reactive protein in patients with coronary heart disease before and after percutaneous coronary intervention (PCI).Methods Forty patients with coronary heart disease that treated with PCI were enrolled.The serum concentration of C-reactive protein (CRP) was analyzed before and after the PCI.Results After PCI,the concentration of CRP were significantly increased compared with that before PCI[(13.91±3.61 ) mg/L versus ( 7.86±3.58 )mg/L,P＜0.01].Conclusion The concentrations of CRP in patients with coronary heart disease were significantly increased after PCI.The level of serum Hs-CRP may reflect inflammatory state of atherosclerosis plaque and it may be important to the prevention and treatment of complications after PCI.     

缬沙坦联合贝那普利治疗慢性心力衰竭的疗效观察

Objective To observe the effect of valsartan combined with benazepril in treatment of patients with chronic heart failure. Methods 60 patients with heart failure of New York Heart Association (NYHA) class Ⅱ -Ⅳ and LVEF less than or equal 40% were selected and randomly divided into two groups. The patients in control group were given benazepril(10mg/d) alone,and the patients in treatment group were given valsartan(80mg/d) combined with benazepril(10mg/d). After 8 months therapy, the changes of the parameters of left ventriclular function and ventriclular dimension of the patients with chronic heart failure were compared before and after treatment. And the clinical efficacy was compared between two groups. Results The ventriclular dimension of the patients with chronic heart failure was decreased,and left ventriclular function was improved. The patients of the combination therapy group were improved especially after treatment. Conclusion Angiotensin-converting-enzyme(ACE) inhibitor could improve heart function of patients with chronic heart failure. Therapy of valsartan combined with benazepril was more effective.     

二尖瓣球囊成形术前后心房利钠肽的变化及预后预测价值

目的探讨风湿性二尖瓣狭窄患者行经皮球囊二尖瓣成形术（PBMV）前后心房利钠肽（ANP）的变化及术前ANP在预测预后中的价值。方法选择成功行PBMV术并有完整随访资料的风湿性二尖瓣狭窄患者32例。于PBMV术前及术后1d取静脉血,用放射免疫法测定血浆ANP值,术前、术后1d及18个月随访时行超声心动图测二尖瓣口面积（MVA）。依据纽约心脏病学会标准评价患者心功能。结果术前ANP值在MVA〉0．8cm^2与≤0．8cm^2者分别为（186．41±76．82）ng／L及（247．61±55．05）ng／L（P〈0．05）、心功能Ⅱ级与Ⅲ级者分别为（188．63±65．34）ng／L与（249．22±67．18）ng／L（P〈0．05）。术前ANP值与MVA呈负相关（r=-0．536,P〈0．01）、与心功能呈正相关（r=0．416,P〈0．01）。3例（9．4％）发生再狭窄,再狭窄患者术前心功能差、MVA小、ANP值高。结论风湿性二尖瓣狭窄患者PBMV术前ANP值是除年龄、病程、MVA、心功能等不良预后因素之外的又一预测疗效的可靠指标。     

美托洛尔对老年患者心功能及心率变异性的影响

目的评价美托洛尔对老年患者心功能及心率变异性(HRV)的影响。方法心血管病老年患者426例,年龄≥70岁,口服美托洛尔治疗12个月。观察治疗前、治疗12个月后BP、HR、HRV(340例窦性心律患者)、左室收缩末期容积(LVESV)和舒张末期容积(LVEDV)、左室射血分数(LVEF)和心排血量(CO)的变化。结果与治疗前比较,治疗后BP、HR明显降低(P<0.05),LVEDV及LVESV明显降低[(173.22±45.42)ml vs.(158.55±40.34)ml和(150.34±54.14)mlvs.(134.65±44.02)ml](P<0.05)],而LVEF和CO明显增加[(56.16±3.26)%vs.(60.25±4.05)%和(4.2±1.2)L vs.(5.4±1.9)L](P<0.05)]。HRV各参数均较治疗前明显升高。药物相关的不良反应无明显增加。结论对老年患者,美托洛尔降低心率和血压的同时,明显改善HRV及心功能。     

老年心功能不全患者缺血修饰白蛋白水平及左心室射血分数的变化

目的 研究老年患者不同心功能状态下缺血修饰白蛋白( IMA)水平,左心室射血分数( LVEF)及其两者之间的相关性。方法 2010年4月至2011年6月入住我院急诊科病房及ICU的84例心功能不全患者,将84例患者按美国纽约心脏病学会(NYHA)分级分为3组Ⅱ、Ⅲ、Ⅳ级组,另按照病情转归将患者分为症状缓解组及病情加重/死亡组,记录患者病史、常规血生化监测、测定IMA及行心脏彩超检查。分析IMA与LVEF的相关性。结果 心功能Ⅱ级组的血清IMA[(45.24±11.31) U/ml]明显低于心功能Ⅲ级组[(60.43±10.73) U/ml]和Ⅳ级组[(86.42±12.25)U/ml],差异有统计学意义(P＜0.05);症状缓解组治疗后IMA降低[(70.12±12.41) U/ml比(48.94±10.34) U/ml],该组治疗前后IMA、LVEF比较,差异有统计学意义(P＜0.05);病情加重/死亡组治疗后IMA升高[(81.18±11.47) U/ml比(64.40±10.78) U/ml],该组治疗前后IMA、LVEF比较,差异有统计学意义(P＜0.05);缓解组与病情加重/死亡组治疗前血IMA、LVEF及治疗后血IMA、LVEF组间比较差异有统计学意义(P＜0.05)。IMA与LVEF呈负相关(r=-0.619,P＜0.01)。结论 老年心功能不全患者血浆IMA浓度明显升高,并与NYHA心功能分级呈正相关,与LVEF呈负相关,经过治疗病情平稳后IMA水平回落。     

慢性充血性心力衰竭血浆脑钠肽的变化及其对预后的影响

目的探讨慢性充血性心力衰竭（CHF）患者血浆脑钠肽（BNP）水平的变化及其临床意义。方法选择CHF患者66例,于治疗前后分别测定血浆BNP水平并与30名健康者为对照。结果 CHD组患者的血浆BNP、LVEDD、LVESD和心胸比值较对照组明显增加,LVEF较对照组明显减低,差异均有统计学意义（P〈0.01）;CHF患者血浆BNP水平随着NYHA心功能的加重而上升,差异有统计学意义（P〈0.05或0.01）;BNP与LVEF呈负相关（γ=-0.652,P〈0.01）,BNP与LVEDD、LVESD和心胸比值呈正相关（γ=0.578,0.592,0.613,P〈0.01）;发生事件组（22例）血浆BNP（222.43±13.43）ng/L,明显高于未发生事件组（44例）血浆BNP（133.49±25.28）ng/L,两组间有显著统计学差异（P〈0.01）;44例未发生事件组CHF患者治疗后血浆BNP水平明显降低,LVEF增高,心胸比值降低（P〈0.05）。结论血浆BNP水平和心脏结构相关,可作为反映心功能状态的指标,可作为CHF诊断、病情和预后判定的重要指标。     

充血性心力衰竭患者甲状腺激素及心功能改变的临床研究

目的 探讨充血性心力衰竭(CHF)患者甲状腺激素变化和心功能的关系。方法 用放射免疫法测定36例CHF患者（CHF组）和同期健康体检者23例（正常对照组）血清三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、反三碘甲状腺原氨酸(rT3)及促甲状腺素,用超声心动图测定心排血量(CO)、左心室射血分数(LVEF)、左心室舒张末容积(LVEDV)和左心室收缩末容积(LVESV)。结果 CHF组心功能Ⅲ、Ⅳ级患者（分别为16、10例）T3水平和LVEF、CO明显低于正常对照组[T3：(1.6±0.2) nmol/L、(1.5±0.2)nmol/L 比(2.0±0.3) nmol/L,LVEF:(54.4±8.3)％、(51.3±11.1)％比(59.0±8.9)％,CO:(4.3±2.6) L/min、(4.1±2.6) L/min比(5.5±1.6) L/min,P＜0.05或P＜0.01],rT3和LVEDV、LVESV明显高于正常对照组[rT3:(0.6±0.3)nmol/L、(0.6±0.4)nmol/L比(0.3 ±0.1)nmol/L,LVEDV:(202±46)ml、(234±65)ml比(175±53) ml,LVESV：( 149±57) ml、(160±59)ml比(124±56)ml,P＜0.01],且随着心力衰竭程度加重,其变化越明显。结论 甲状腺激素变化对CHF患者心功能损害程度、治疗及预后具有重要意义。     

左西孟旦联合托伐普坦治疗失代偿性心力衰竭的临床效果

目的 探讨左西孟旦联合托伐普坦治疗失代偿性心力衰竭的临床效果.方法 120例失代偿性心力衰竭患者,按随机数字表法分为观察组和对照组,各60例.对照组给予托伐普坦治疗,观察组在对照组的基础上加用左西孟旦治疗.比较两组患者治疗前后的血浆内皮素(ET)、脑钠肽(BNP)水平,心功能指标[左室射血分数(LVEF)、左室舒张末期...     

卡维地洛治疗糖尿病合并冠心病心力衰竭的疗效观察

目的 观察卡维地洛对2型糖尿病并发冠心病心力衰竭的心功能及血脂、血糖、胰岛素抵抗、C-反应蛋白的影响.方法 选择伴2型糖尿病并心病心力衰竭患者60例,随机分为对照组30例和治疗组30例,治疗前及治疗后1年分别观察左室舒张末期内径(LVEDD)、收缩末期内径(LVESD)、左室射血分数(LVEF)、血脂、血糖(FPG)、C-反应蛋白(CRP)、胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)、6 min步行试验(6MHW)、NYHA分级.结果 治疗组心功能治疗前后比较:分级:X2=3.12,P＜0.05;LVEF:t=2.377,P＜0.05;LVEDD、LVESD:t=2.367,t=2.289,P＜0.05;LVEF(0.50 ±0.08)%高于对照组(0.45±0.06)%(t=2.357,P＜0.05);治疗组治疗后LVEDD、LVESD(50.74±2.05 mm、32.17±2.32 mm)均低于对照组(61.45±3.72 mm、39.32±1.91 mm)(t=2.217,t=2.319,P＜0.05);治疗组治疗后C-反应蛋白(7.56±3.25)mg/L低于治疗前(10.99±4.26)mg/L(t=2.317,P＜0.05).结论 卡维地洛能明显逆转2型糖尿病并心力衰竭的心室重塑、改善心功能和血糖代谢.     

不同剂量螺内酯对扩张型心肌病心力衰竭患者心功能和血浆脑钠肽的影响

目的观察不同剂量螺内酯对扩张型心肌病（dilated cardiomyopathy,DCM）心力衰竭患者心功能和血浆脑钠肽（BNP）的影响。方法将扩张型心肌病心力衰竭患者（NYHA心功能分级Ⅲ-Ⅳ级）110例,随机分为小剂量组和大剂量组各55例,两组在常规抗心衰治疗基础上小剂量组给予螺内酯20mg／d,大剂量组给予螺内酯60mg／d,经治疗6个月后评价患者的心功能和检测血浆BNP进行比较。结果两组治疗前后NYHA心功能分级比较均有明显好转（P〈0．01）;小剂量组螺内酯治疗前LVEF（31．23±3．61）％与大剂量组螺内酯治疗前LVEF（30．33±3．27）％比较,差异无统计学意义（P〉0．05）;小剂量组螺内酯治疗后LVEF（39．37±8．30）％与大剂量组螺内酯治疗后LVEF（45．17±5．33）％比较,差异有统计学意义（P〈0．05）;小剂量组螺内酯治疗前血浆BNP（973．25±256．23）pg／ml与大剂量组螺内酯治疗前血浆BNP（991．07±211．35）pg／ml比较,差异无统计学意义（P〉0．05）;小剂量组螺内酯治疗后血浆BNP（324．12±122．43）pg／ml与大剂量组螺内酯治疗后血浆BNP（200．58±145．11）pg／ml比较,差异有统计学意义（P〈0．05）。但是,大剂量组螺内酯治疗前后比小剂量组下降更明显,两者比较差异有统计学意义（P〈0．05）;小剂量组和大剂量组的不良反应发生率为11．1％和8．82％,差异无统计学意义（P〉0．05）。结论在常规用药基础上采用大剂量螺内酯可以降低BNP水平,明显改善扩张性心肌病心力衰竭患者的心功能,疗效较好。     

重组人脑利钠肽对心力衰竭患者心功能、炎症指标、血浆N末端脑钠肽原、尿量的影响

目的观察重组人脑利钠肽对心力衰竭患者心功能、炎症指标、血浆N末端脑钠肽原、尿量的影响。方法80例心力衰竭患者,采用随机数字表法分为对照组及观察组,每组40例。对照组采用常规药物治疗,观察组在对照组的基础上联合重组人脑利钠肽治疗。比较两组患者的心功能、炎症指标、血浆N末端脑钠肽原、尿量水平。结果观察组患者的左室收缩末期内径(42.6±4.1)mm小于对照组的(45.3±4.5)mm,左室射血分数(48.5±5.8)%高于对照组的(44.5±5.1)%,差异具有统计学意义(P<0.05);两组患者的左室舒张末期内径、心脏指数、每搏输出量比较,差异无统计学意义(P>0.05)。观察组患者的白介素-6(36.4±4.6)ng/L、超敏C反应蛋白(1.3±0.4)mg/L、血浆N末端脑钠肽原(1132.5±484.0)pg/ml低于对照组的(51.2±5.2)ng/L、(2.7±0.5)mg/L、(1425.6±495.2)pg/ml,24 h尿量(1267.5±120.5)ml多于对照组的(1024.5±112.5)ml,差异具有统计学意义(P<0.05)。结论重组人脑利钠肽治疗心力衰竭的效果明显,可显著改善心功能和炎症指标水平。     

心脏型脂肪酸结合蛋白在非瓣膜型慢性心力衰竭中的价值

目的探讨非瓣膜型慢性心力衰竭患者血清心脏型脂肪酸结合蛋白（H-FABP）水平及临床意义。方法选择非瓣膜型不同心功能级别患者35例及健康体检者20例,测定血清H—FABP、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）浓度,同时观察住院期间及随访2个月心脏事件与非心脏事件发生情况H．FABP水平。结果H—FABP浓度在心功能Ⅱ级、Ⅲ级、Ⅳ级组分别是（4．30±1．28）、（6．06±1．03）、（7．64±1．56）ng／ml。两两比较,差异均有统计学意义（P〈0．05）。与对照组比较,心功能Ⅱ级组差异无统计学意义（P〉0．05）,余差异均有统计学意义（P〈0．05）;CK浓度在心力衰竭各亚组及对照组间差异均无统计学意义（P〉O．05）;CK-MB浓度在心功能Ⅳ级组与其他心力衰竭亚组及对照组间差异均有统计学意义（P〈0．05）,余各组间比较差异均无统计学意义（P〉0．05）。住院期间及随访2个月发生心脏事件的H-FABP浓度（7．95±1．30）ng／ml与非心脏事件的H-FABP浓度（5．02±1．31）ng／ml相比,差异有统计学意义（P〈0．05）。结论H-FABP对判断非瓣膜型慢性心力衰竭患者心肌损伤程度及预后有重要临床价值。