血清脂联素在心力衰竭患者中的变化及与心功能的相关性研究

目的探讨血清脂联素(APN)水平与心力衰竭患者心功能、肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hsCRP)及胰岛素抵抗(HOMA-IR)的相关性。方法随机选择心力衰竭患者100例,按NYHA心功能分级分为3组:Ⅱ级34例;Ⅲ级32例;Ⅳ级34例。健康对照组30名。采用酶联免疫吸附法测定血清APN水平,免疫比浊法测定hsCRP,放射免疫分析法测定血清TNF-α与空腹胰岛素(FINS)水平,氧化酶法测定空腹血糖(FBG)水平,并计算胰岛素抵抗指数。结果心力衰竭组APN水平较对照组明显降低(P<0.05),且随着心力衰竭程度加重,APN水平降低更加明显。APN与TNF-α、hsCRP、HOMA-IR呈负相关(r=-0.118,P<0.01;r=-0.578,P<0.01;r=-0.446,P<0.01)。结论心力衰竭患者血清APN水平明显降低,且随着心功能损害程度加重而降低更加明显。APN在心力衰竭过程中起着重要作用,可作为评价心力衰竭患者病情严重程度的易测指标。

Relationship between serum adiponectin and cardiac function of patients with heart failure

Objective To investigate the correlations of serum adiponectin to tumor-necrosis factor-alpha （TNF-α）, C reactive protein （CRP）, insulin resistance （IR） and cardiac function in patients with heart failure. Methotis One hundred consecutive patients were enrolled and divided into three groups： NYHA Ⅱ （n=34）, NYHA Ⅲ （n= 32） and NYHA Ⅳ（n=34）. Thirty healthy individuals were included as controls. Serum adiponectin was evaluated using enzyme-linked immunosorbent assay, plasma level of hs-CRP assessed with immunoturbidimetry, concentration of TNF-α and fasting insulin （FINS） examined by radioimmunoassay. Results The concentrations of adiponectin were significantly lower in patients than in healthy controls （P〈0.05）. Lower level of adiponection was also shown to be associated with more severe form of heart failure. Negative correlations were found between adiponectin and TNF-α （r=-0.118, P〈0.01）, hsCRP （r=-0.578, P〈0.01） and HOMA-IR （r=-0.446, P〈0.01）. Conclusion The level of the adiponectin in heart failure was found to decline along with the degree of the cardiac function. The important role of adiponectin in the process of heart failure may iustifv its use as a biomarker for this condition.